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Ann Thorac Surg 1982;33:258-266
© 1982 The Society of Thoracic Surgeons

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Articles

Circulatory Dynamics during Surface-Induced Hypothermia under Halothane-Ether Azeotrope Anesthesia

From the Division of Cardiothoracic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA

Accepted for publication May 11, 1981.

^* Address reprint requests to Dr. Dillard, Division of Cardiothoracic Surgery, Department of Surgery, University of Washington School of Medicine, BB 438, RF-25, Seattle, WA 98195

Circulatory dynamics during surface-induced deep hypothermia using the halothanediethyl ether azeotrope in 100% oxygen (O₂) without circulatory arrest and in 95% O₂ and 5% carbon dioxide (CO₂) with and without 60 minutes of arrest were evaluated in 15 adult mongrel dogs. Mean arterial pressure was lower in animals given 5% CO₂ than in animals given 100% O₂ during cooling. Cardiac output in the 5% CO₂ groups increased until 30°C cooling and then gradually decreased to 29% of control at 20°C. Cardiac output in the 100% O₂ group progressively decreased to 16% of control at 20°C cooling and was 51 to 77% of the output in the 5% CO₂ animals at comparable temperatures throughout the hypothermia procedure. The differences in cardiac output were attributed primarily to changes in stroke volume since heart rates were not significantly different. These changes were probably secondary to differences in systemic vascular resistance, which had increased sixfold in the animals given 100% O₂ and had only doubled in the 5% CO₂ groups at 20°C during cooling. Hemodynamic variables in animals given 5% CO₂ did not reveal significant differences in arrested versus nonarrested animals during early rewarming. However, with further warming, cardiac output, stroke volume, left ventricular stroke work, and mean pulmonary arterial and pulmonary artery wedge pressures were lower, and systemic and pulmonary vascular resistances were higher in the arrest group. We conclude that the improved results with halothane–diethyl ether azeotrope in 95% O₂ and 5% CO₂ during surface hypothermia are due to a greater cardiac output and reduced peripheral vascular resistance.

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