Upper-Silesian Heart Center, Department of Cardiac Surgery, 40-635 Katowice, Poland.
Department of Cardiac Surgery, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland.
Int J Environ Res Public Health. 2021 Jul 1;18(13):7061. doi: 10.3390/ijerph18137061.
Hypothermia is defined as a decrease in body core temperature to below 35 °C. In cardiac surgery, four stages of hypothermia are distinguished: mild, moderate, deep, and profound. The organ protection offered by deep hypothermia (DH) enables safe circulatory arrest as a prerequisite to carrying out cardiac surgical intervention. In adult cardiac surgery, DH is mainly used in aortic arch surgery, surgical treatment of pulmonary embolism, and acute type-A aortic dissection interventions. In surgery treating congenital defects, DH is used to assist aortic arch reconstructions, hypoplastic left heart syndrome interventions, and for multi-stage treatment of infants with a single heart ventricle during the neonatal period. However, it should be noted that a safe duration of circulatory arrest in DH for the central nervous system is 30 to 40 min at most and should not be exceeded to prevent severe neurological adverse events. Personalized therapy for the patient and adequate blood temperature monitoring, glycemia, hematocrit, pH, and cerebral oxygenation is a prerequisite and indispensable part of DH.
低体温是指核心体温降至 35°C 以下。在心脏外科手术中，将低体温分为四个阶段：轻度、中度、深度和极深度。深度低体温（DH）提供的器官保护使安全的循环停止成为进行心脏外科干预的先决条件。在成人心脏外科手术中，DH 主要用于主动脉弓手术、肺栓塞的外科治疗以及急性 A 型主动脉夹层干预。在先天性缺陷的手术治疗中，DH 用于辅助主动脉弓重建、左心发育不全综合征的干预以及新生儿单心室的多阶段治疗。但是，应当注意的是，DH 中用于中枢神经系统的安全循环停止时间最多为 30 至 40 分钟，不应超过以防止严重的神经不良事件。对患者进行个体化治疗以及充分的血液温度监测、血糖、血细胞比容、pH 值和脑氧合是 DH 的前提和不可或缺的部分。
