Deep hypothermia

Deep hypothermia , English deep hypothermia , also hypothermic cardiac arrest ( hypothermic cardiac arrest HCA, also deep hypothermic arrest , DHA) is an intentional hypothermia (sub-cooling) of the human body for the purpose of general anesthesia for short-term operation . This leads to unconsciousness and cardiac arrest.

This hypothermia is sometimes used artificially during operations on the brain , or to protect the brain during operations on the main artery . It allows the blood flow to the patient's brain to be reduced or completely shut down for a short time during the operation.

A modified heart-lung machine is used for this. The blood is cooled to 14-20 ° C in a heat exchanger outside the body. The operating room is also cooled. In addition, the patient's head can be cooled with ice packs. When the desired core body temperature has been reached, the surgeon interrupts the heart's activity with an ice-cold potassium chloride solution (known as cardioplegia ). The operation can then be carried out blood-free with excellent visibility.

The oxygen consumption of the brain cooled to 20 ° C sinks to 15%; this increases the time during which complete cardiac arrest can be tolerated from the normal three minutes to up to an hour. As a rule, the operations take 20-30 minutes.

Disadvantages are the high expenditure on equipment and an increased risk of strokes and blood clots.

It was first described in 1960 by the American neurosurgeon Barnes Woodhall .

A therapeutic hypothermia that uses less low temperatures is called mild hypothermia .

source

• RD Rothoerl, A. Brawanski: The history and present status of deep hypothermia and circulatory arrest in cerebrovascular surgery . In: Neurosurgical Focus , 2006, 20 (6): E5, 2006 PMID 16819813 .

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