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Seminars in Cardiothoracic and Vascular Anesthesia
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Deep Hypothermia and Circulatory Arrest in Adults

Ihab Dorotta, MD, ChB

Department of Anesthesiology, Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354; dorottas{at}msn.net

Penny Kimball-Jones, MD

Richard Applegate, II, MD

Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, California

Brain protection during cardiopulmonary bypass has been the subject of intense research. Deep hypothermic circulatory arrest (DHCA) continues to be used for that goal during complex aortic arch and large intracranial aneurysm surgeries. The anesthetic management for adult patients undergoing these types of procedures requires specific knowledge and expertise. Based on our experience and review of the current literature, the authors highlight the key areas of the anesthetic plan, discussing the risk factors associated with adverse neurologic outcome as well as the rationale for decisions regarding specific monitors and medications. In the conclusion an anesthetic protocol for adult patients undergoing DHCA is suggested.

Key Words: deep hypothermic circulatory arrest • circulatory arrest • hypothermia for brain protection

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 11, No. 1, 66-76 (2007)
DOI: 10.1177/1089253206297482
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