1.Clinical Applications and Pitfalls of Hypothermia in Patients after Fontan's Operation.
Hideaki Ohno ; Yasuharu Imai ; Shuichi Hoshino ; Kazuaki Ishihara ; Seisuke Nakata ; Kazuhiro Seo ; Hiroyasu Misumi ; Masatugu Terada ; Takamasa Takeuchi ; Toshiharu Shin'oka
Japanese Journal of Cardiovascular Surgery 1996;25(1):7-12
This study was designed to clarify the usefulness and pitfalls of hypothermic management after Fontan's operation. Twenty-five patients who underwent Fontan's operation and received hypothermic management in an acute postoperative phase from 1974 to 1991 were divided into two groups; the alive (S) group and the dead (D) group. The lowest rectal temperature during the procedure was 32°C on average. There were no significant differences in preoperative indices of pulmonary circulation and renal function. After rewarming, PaO2 and daily urinary output were increased and central venous pressure decreased significantly in the S group. In all S group patients, urinary output was increased during hypothermia irrespective of peritoneal dialysis. Anuria occurred 2 days on average after induction of hypothermia in D group. Urinary output in D group decreased significantly for 4 days compared to S group. On the other hand, it was possible to save two patients who underwent take-down of Fontan's operation within 6 hours after the onset of anuria. We conclude that hypothermic management is useful in serious cases after Fontan's operation and that daily urinary output in relation to body weight during hypothermia is most important as an index of post operative circulation.
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