Cooling and rewarming rates, alpha-stat versus pH-stat, cerebral protection, selective antegrade perfusion, and temperature monitoring sites.
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- What does DHCA stand for in cardiac surgery?
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Deep hypothermic circulatory arrest- What core temperature range defines mild hypothermia on CPB?
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32 to 35 degrees C- What core temperature range defines moderate hypothermia on CPB?
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26 to 31 degrees C- What core temperature range defines deep hypothermia on CPB?
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20 to 25 degrees C- What core temperature range defines profound hypothermia on CPB?
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Below 20 degrees C- Roughly how much does cerebral metabolic rate fall for each 1 degree C drop in temperature?
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About 6 to 7 percent- About how long is DHCA at 18 degrees C generally considered a safe duration before neurologic injury risk rises sharply?
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Approximately 30 to 40 minutes- What is the generally accepted maximum temperature gradient between arterial perfusate and venous blood during cooling or rewarming on CPB?
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10 degrees C or less- Why is the arterial to venous temperature gradient limited during cooling and rewarming?
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A larger gradient risks gaseous microemboli, because gas solubility in blood changes rapidly with temperature- What is the recommended maximum arterial outflow temperature during rewarming on CPB?
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It should not exceed about 37 degrees C- Why must cerebral hyperthermia be avoided during rewarming?
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Brain temperature above 37 degrees C increases cerebral metabolic demand and worsens neurologic outcome- In general, how does rewarming rate on CPB compare to cooling rate?
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Rewarming is performed more slowly than cooling- Define the alpha-stat acid-base management strategy.
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A strategy that keeps blood gases at a constant pH of 7.40 and PaCO2 of 40 mmHg when measured and corrected to 37 degrees C, regardless of the patient's actual temperature- Define the pH-stat acid-base management strategy.
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A strategy that adds CO2 during cooling to maintain a pH of 7.40 and PaCO2 of 40 mmHg at the patient's actual (temperature-corrected) body temperature- Which acid-base strategy measures blood gases uncorrected for the patient's actual temperature, always referencing 37 degrees C?
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Alpha-stat
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