Diaz J H, Cooper E S, Ochsner J L
Arch Intern Med. 1984 Aug;144(8):1639-41. doi: 10.1001/archinte.144.8.1639.
The widespread induction of systemic hypothermia and use of iced cardioplegic solutions in cardiac surgery may promote occasional cold autoagglutination. Routine laboratory methods used to detect cold-agglutinating autoantibodies may not take into account the extremely low temperatures that the heart and body may attain during cardiopulmonary bypass. Several cold-mediated complications have now been encountered during cardiac surgery in patients with both known and unsuspected cold-reactive autoantibodies. This review will provide the clinician with a working knowledge of the cold autoimmune disorders, a rapid method for differential diagnosis in unproved cases, and an ability to select techniques for reliable myocardial and renal protection in both known and unsuspected cases.
心脏手术中全身低温的广泛诱导以及冰屑心脏停搏液的使用可能会偶尔引发冷自身凝集。用于检测冷凝集自身抗体的常规实验室方法可能未考虑到心肺转流期间心脏和身体可能达到的极低温度。目前，在已知和未被怀疑存在冷反应性自身抗体的患者进行心脏手术期间，已经出现了几种由寒冷介导的并发症。本综述将为临床医生提供有关冷自身免疫性疾病的实用知识、对未经证实的病例进行鉴别诊断的快速方法，以及在已知和未被怀疑的病例中选择可靠的心肌和肾脏保护技术的能力。
