Determinants of mortality after hypothermic circulatory arrest in a chronic porcine model
| Autor: | Vilho Vainionpää, Jussi Rimpiläinen, Tatu Juvonen, Kai Kiviluoma, Fausto Biancari, Vesa Anttila, Matti Pokela, Pekka Romsi |
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| Rok vydání: | 2001 |
| Předmět: |
Pulmonary and Respiratory Medicine
Swine chemistry.chemical_element Anesthesia General Oxygen Oxygen Consumption Cause of Death medicine Animals Ketamine Survival rate Oxygen saturation (medicine) business.industry Mortality rate Hemodynamics General Medicine Hypothermia Survival Analysis Medetomidine Disease Models Animal chemistry Anesthesia Circulatory system Heart Arrest Induced Female Surgery medicine.symptom Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 20:803-810 |
| ISSN: | 1010-7940 |
| Popis: | Objective: Beside neurological morbidity, mortality is a relevant end-point of experimental porcine model of hypothermic circulatory arrest (HCA) and this study was conducted to identify the determinants for postoperative death. Methods: One hundred and thirty-five pigs underwent a 75-min period of HCA at 208C to evaluate the efficacy of different methods of cerebral protection. Results: Survival rate at 7-day followup was 52%. Lower oxygen extraction, oxygen consumption/kg, and venous lactate at the end of cooling and higher oxygen delivery rates were significantly associated with better outcome. Logistic regression showed that the oxygen consumption/kg at the end of cooling was the only predictor of mortality (P ¼ 0:046). Animals with an oxygen consumption/kg rate less than 1.43 ml/min per kg at the end of cooling had a mortality rate of 28%, whereas it was 50% among animals with an oxygen consumption/kg rate higher or equal to 1.43 ml/min per kg (P ¼ 0:020). The latter had even an increased 1-day mortality rate (40% vs. 26%) (P not significant). The mortality rate after anesthesia induction with ketamine plus 100% of oxygen was 38%, 45% after anesthesia induction with ketamine plus 35% oxygen, and 53% after anesthesia with medetomidine plus 35% oxygen (P not significant). Conclusions: Parameters of oxyhemodynamics should be monitored especially from the induction of anesthesia to the end of cooling before a 75-min period of HCA. The use of medetomidine and/or 35% of oxygen at induction of anesthesia should be avoided in favor of ketamine plus 100% of oxygen. q 2001 Elsevier Science B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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