Randomized controlled trial of moderate hypothermia versus deep hypothermia anesthesia on brain injury during Stanford A aortic dissection surgery

Heart Vessels. 2018 Jan;33(1):66-71. doi: 10.1007/s00380-017-1037-9. Epub 2017 Aug 23.

Abstract

This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used. The intraoperative and postoperative indicators of these patients were recorded. There were no differences in intraoperative and postoperative measures between MH and DH groups. The concentrations of neuron-specific enolase and S-100β increased with operation time, and were significantly lower in MH group than those in the DH group (P < 0.05). The occurrence rates of complications including chenosis, postoperative agitation, and neurological complications in MH group were significantly lower than in DH group. The recovery time, postoperative tube, and ICU intubation stay were significantly shorter in MH group than those in DH group (P < 0.05). There were no significant differences revealed in hospital stay and death rate. MH exhibited better cerebral protective effects, less complications, and shorter tube time than DH in surgery for Stanford A aortic dissection.

Keywords: Cerebral injury; Deep hypothermia anesthesia; Moderate hypothermia anesthesia; Stanford A aortic dissection.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Anesthesia / methods*
  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnosis
  • Aortic Dissection / surgery*
  • Body Temperature
  • Brain Injuries / epidemiology
  • Brain Injuries / etiology
  • Brain Injuries / prevention & control*
  • China / epidemiology
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Hypothermia, Induced / methods*
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Survival Rate / trends
  • Treatment Outcome
  • Vascular Surgical Procedures / methods*
  • Young Adult