title: Brief review on systematic hypothermia for the protection of central nervous system during aortic arch surgery: a double-sword tool?
abstract: Antegrade selective cerebral perfusion in conjunction with hypothermia attenuate postoperative neurological injury, which in turn still remains the main cause of mortality and morbidity following aortic arch surgery. Hypothermic circulatory arrest however could be a useful tool during arch surgery, surgery for chronic thromboembolic disease, air on the arterial line during CPB, during cavotomy for extraction of renal cell carcinoma with level IV extension, or when dealing with difficult trauma to the SVC or IVC. Cerebral protective effects with hypothermic procedures including inhibition of neuron excitation, and discharge of excitable amino acids, and thereby, prevention of an increase in intercellular calcium ions, hyperoxidation of lipids in cell membranes, and free radical production.The authors are briefly discussing the fundamental principles of using hypothermia as an adjunct tool of the cardiothoracic surgeon's practice. The relationship between temperature, flow, metabolic requirements and adverse effects is addressed.
authors.forename: Haralabos
authors.initials: H
authors.lastname: Parissis
authors.forename: Umar
authors.initials: U
authors.lastname: Hamid
authors.forename: Alan
authors.initials: A
authors.lastname: Soo
authors.forename: Bassel
authors.initials: B
authors.lastname: Al-Alao
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000503:physiopathology / Q000601:surgery*; D002490:Central Nervous System / Q000503:physiopathology*; D002493:Central Nervous System Diseases / Q000503:physiopathology / Q000517:prevention & control*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D006801:Humans; D014656:Vascular Surgical Procedures / Q000379:methods*
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