Rosenfeldt F L, Arnold M
Ann Thorac Surg. 1982 Aug;34(2):138-45. doi: 10.1016/s0003-4975(10)60874-0.
Topical cardiac cooling plays an important part in maintaining myocardial hypothermia during cardiac operations under hypothermic cardioplegic arrest. We have compared two systems of topical cooling in which the cooling fluid is recirculated. In one system the cold fluid circulates through a sealed plastic cooling pad wrapped around the heart; in the other it is sprayed over the surface of the heart. In dogs undergoing 60 minutes of hypothermic cardioplegic arrest, the cooling pad was ineffective: it did not adequately cool the anterior left ventricular wall or the interventricular septum. Under the same conditions, the spray system produced myocardial temperatures 6 degrees to 12 degrees C lower than the cooling pad system. In limited clinical tests, the cooling pad was unable to sustain overall myocardial hypothermia and there was difficulty in maintaining contact between the heart and the pad during coronary operations. Since the topical spray can maintain profound global myocardial hypothermia regardless of the position of the heart, we conclude that it is superior to the cooling pad system.
局部心脏降温在心脏停搏液低温停循环心脏手术期间维持心肌低温方面起着重要作用。我们比较了两种冷却液循环的局部降温系统。在一种系统中，冷流体通过包裹在心脏周围的密封塑料冷却垫循环；在另一种系统中，冷流体被喷洒在心脏表面。在接受60分钟低温心脏停搏的狗身上，冷却垫效果不佳：它不能充分冷却左心室前壁或室间隔。在相同条件下，喷雾系统产生的心肌温度比冷却垫系统低6摄氏度至12摄氏度。在有限的临床试验中，冷却垫无法维持整体心肌低温，并且在冠状动脉手术期间难以维持心脏与垫子之间的接触。由于局部喷雾无论心脏位置如何都能维持深度的整体心肌低温，我们得出结论，它优于冷却垫系统。
