title: Deep Hypothermic Circulatory Arrest in a Patient With Cold-Induced Urticaria.
abstract: Acquired cold urticaria is a condition characterized by the onset of pruritic hives, swelling, and occasional severe systemic reactions, during the rewarming phase, after cold exposure. Pulmonary thromboendarterectomy (PTE) is a cardiac surgical procedure where organized thrombus is excised from the pulmonary vasculature in order to improve pulmonary blood flow and relieve pressure on the right ventricle. A PTE requires institution of deep hypothermic circulatory arrest (DHCA) in order to reduce blood flow from collateral vessels during thrombus excision. We describe a case of PTE performed under DHCA in a patient with ACU.
authors.affiliation: Department of Anesthesia, Critical Care, and Pain Medicine, Division of Cardiac Anesthesia, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fitzsimons
authors.affiliation: Department of Surgery, Division of Cardiac Surgery Division, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Gus
authors.initials: G
authors.lastname: Vlahakes
authors.affiliation: Department of Pathology, Blood Transfusion Service, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Robert
authors.initials: R
authors.lastname: Makar
authors.affiliation: Department of Anesthesia, Critical Care, and Pain Medicine, Division of Cardiac Anesthesia, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: joshuaddilley@gmail.com.
authors.forename: Joshua
authors.initials: J
authors.lastname: Dilley
authors.affiliation: Department of Surgery, Thoracic Surgery Division, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Cameron
authors.initials: C
authors.lastname: Wright
authors.affiliation: Department of Pathology, Coagulation Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Van Cott
authors.affiliation: Department of Pathology, Clinical Immunology Laboratory, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Mandakolathur
authors.initials: M
authors.lastname: Murali
mesh_terms: D050792:Circulatory Arrest, Deep Hypothermia Induced; D003080:Cold Temperature / Q000009:adverse effects*; D004691:Endarterectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000601:surgery*; D012307:Risk Factors; D014581:Urticaria / Q000209:etiology*