Aortic Surgery
Impact of perioperative mild hypothermia on neurological function and prognosis of patients with acute type A aortic dissection
Xiao Shen, Cui Zhang, Xiaochun Song, Lei Zou, Run Fu, Xinwei Mu, Liqiong Xiao, Fuhua Huang
Published 2018-11-25
Cite as Chin J Thorac Cardiovasc Surg, 2018, 34(11): 655-658. DOI: 10.3760/cma.j.issn.1001-4497.2018.11.004
Abstract
ObjectiveTo investigate the impact of perioperative mild hypothermia on the neurological function and prognosis of patients with acute type A aortic dissection.
MethodsThis study enrolled 65 patients with acute aortic dissection underwent surgery during the period of February 2017 to February 2018 and randomly divided them into mild hypothermia group and control group. After the process of deep hypothermic circulatory arrest, patients in the mild hypothermia group were rewarmed to 34 ℃-35 ℃ and maintained until 24 h after the operation. While, the patients in the control group were rewarmed to 36 ℃ and were treated with routine rewarm therapy. Baseline characteristics were recorded before the operation and neurological and prognosis related indexes were recorded after the operation for all the patients. At the same time, peripheral venous bloods of all the patients were collected preoperatively and at 1、6、12 and 24 h after the operation. Serum S100β and neuron-specific enolase(NSE) levels were measured by ELISA kit.
ResultsCompared with the control group, patients in the mild hypothermia group had a significantly shorter recovery time[10.6 h(IQR: 7.6, 19.1) vs. 25.8 h(IQR: 13.3, 54.2), P=0.007]. At the same time, serum levels of NSE at 1 h and 6 h after operation and serum levels of S100β levels at 1、6、12 and 24 h after operation in the mild hypothermia group were significantly lower than those in the control group(P<0.05). In addition, the length of stay in the mild hypothermia group was significantly shorter than that in the control group[19 days(IQR: 17, 23) vs. 24 days(IQR: 17, 28), P=0.036]. However, there was no statistically difference in the incidence of delirium and cerebrovascular accidents between the two groups.
ConclusionPerioperative mild hypothermia therapy can significantly reduce brain cell damage in the patients with acute type A aortic dissection and can shorten postoperative recovery time and hospitalization time, and thus improve the prognosis of patients.
Key words:
Mild hypothermia; Acute type A aortic dissection; Neurological function; Prognosis
Contributor Information
Xiao Shen
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Cui Zhang
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Xiaochun Song
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Lei Zou
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Run Fu
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Xinwei Mu
Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Liqiong Xiao
Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
Fuhua Huang
Department of Cardiothoracic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China
