Puca A, Spetzler R F, Zabramski J M, Culicchia F
Istituto di Neurochirurgia, Università Cattolica, Roma.
Ital J Neurol Sci. 1991 Feb;12(1):49-55. doi: 10.1007/BF02337614.
Direct surgical attack on intracranial malformations of great complexity may be facilitated by complete cardiocirculatory arrest under hypothermia. To improve the technical aspects of this procedure and to determine the optimum depth of hypothermia, the duration of arrest that can be tolerated, and the role of barbiturate brain protection, we conducted an experimental study on 11 baboons. Arrest lasted for 45 or 90 minutes at a brain temperature of 12 degrees C. The animals were assessed by clinical, neuroradiological and necropsy examination. All 4 animals subjected to 45 minutes arrest made a good clinical recovery while 3 of the 7 subjected to 90 minutes arrest presented thromboembolic complications. Strict heparinization in the last 2 animals solved these problems. The findings of this study may help to make the procedure safer for clinical use.
在低温状态下进行完全的心循环停止,可能有助于对极其复杂的颅内畸形进行直接手术攻击。为了改进该手术的技术方面,并确定最佳的低温深度、可耐受的停止时间以及巴比妥类药物脑保护的作用,我们对11只狒狒进行了一项实验研究。在脑温为12摄氏度时,停止持续45或90分钟。通过临床、神经放射学和尸检检查对动物进行评估。接受45分钟停止的所有4只动物临床恢复良好,而接受90分钟停止的7只动物中有3只出现血栓栓塞并发症。最后2只动物严格肝素化解决了这些问题。本研究结果可能有助于使该手术在临床应用中更安全。