Abstract
Objective: To evaluate fetal-maternal temperature relationship and fetal cardiovascular and metabolic response during maternal hypothermic cardiopulmonary bypass in pregnant ewes. Methods: Cardiopulmonary bypass was instituted in 9 pregnant ewes, reaching 2 different levels of maternal hypothermia: 24°C to 20°C (deep hypothermia) in group A (5 cases) and less than 20°C (very deep hypothermia) in group B (4 cases). Hypothermic levels were maintained for 20 minutes, then the rewarming phase was started. Fetal and maternal temperature, blood pressure, heart rate, electrocardiogram, blood gases, and acid-base balance were evaluated at different levels of hypothermia and during recovery. Results: Fetal survival was related to maternal hypothermia: all group A fetuses survived, while 2 of 4 fetuses of group B in which maternal temperature was lowered below 18°C died in a very deep acidotic and hypoxic status. Maternal temperature was always lower than fetal temperature during cooling; during rewarming the gradient was inverted. The start of cardiopulmonary bypass and cooling was associated with transient fetal tachycardia and hypertension; then, both fetal heart rate and blood pressure progressively decreased. The reduction of fetal heart rate was of 7 beats per minute for each degree of fetal cooling. Deep maternal hypothermia was associated with fetal alkalosis and reduction of PO 2. Very deep hypothermia, in particular below 18°C, caused irreversible fetal acidosis and hypoxia. Conclusions: Deep maternal hypothermic cardiopulmonary bypass was associated with reversible modifications in fetal cardiovascular parameters, blood gases, and acid-base balance and therefore with fetal survival. On the contrary, fetuses did not survive to a very deep hypothermia below 18°C.
| Original language | English |
|---|---|
| Pages (from-to) | 1728-1734 |
| Number of pages | 7 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 127 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2004 |
Fingerprint
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base baance. / Pardi, Giorgio; Ferrari, Maria M.; Iorio, Fiore; Acocella, Fabio; Boero, Veronica; Berlanda, Nicola; Monaco, Ario; Reato, Claudio; Santoro, Francesco; Cetin, Irene.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 127, No. 6, 06.2004, p. 1728-1734.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base baance
AU - Pardi, Giorgio
AU - Ferrari, Maria M.
AU - Iorio, Fiore
AU - Acocella, Fabio
AU - Boero, Veronica
AU - Berlanda, Nicola
AU - Monaco, Ario
AU - Reato, Claudio
AU - Santoro, Francesco
AU - Cetin, Irene
PY - 2004/6
Y1 - 2004/6
N2 - Objective: To evaluate fetal-maternal temperature relationship and fetal cardiovascular and metabolic response during maternal hypothermic cardiopulmonary bypass in pregnant ewes. Methods: Cardiopulmonary bypass was instituted in 9 pregnant ewes, reaching 2 different levels of maternal hypothermia: 24°C to 20°C (deep hypothermia) in group A (5 cases) and less than 20°C (very deep hypothermia) in group B (4 cases). Hypothermic levels were maintained for 20 minutes, then the rewarming phase was started. Fetal and maternal temperature, blood pressure, heart rate, electrocardiogram, blood gases, and acid-base balance were evaluated at different levels of hypothermia and during recovery. Results: Fetal survival was related to maternal hypothermia: all group A fetuses survived, while 2 of 4 fetuses of group B in which maternal temperature was lowered below 18°C died in a very deep acidotic and hypoxic status. Maternal temperature was always lower than fetal temperature during cooling; during rewarming the gradient was inverted. The start of cardiopulmonary bypass and cooling was associated with transient fetal tachycardia and hypertension; then, both fetal heart rate and blood pressure progressively decreased. The reduction of fetal heart rate was of 7 beats per minute for each degree of fetal cooling. Deep maternal hypothermia was associated with fetal alkalosis and reduction of PO 2. Very deep hypothermia, in particular below 18°C, caused irreversible fetal acidosis and hypoxia. Conclusions: Deep maternal hypothermic cardiopulmonary bypass was associated with reversible modifications in fetal cardiovascular parameters, blood gases, and acid-base balance and therefore with fetal survival. On the contrary, fetuses did not survive to a very deep hypothermia below 18°C.
AB - Objective: To evaluate fetal-maternal temperature relationship and fetal cardiovascular and metabolic response during maternal hypothermic cardiopulmonary bypass in pregnant ewes. Methods: Cardiopulmonary bypass was instituted in 9 pregnant ewes, reaching 2 different levels of maternal hypothermia: 24°C to 20°C (deep hypothermia) in group A (5 cases) and less than 20°C (very deep hypothermia) in group B (4 cases). Hypothermic levels were maintained for 20 minutes, then the rewarming phase was started. Fetal and maternal temperature, blood pressure, heart rate, electrocardiogram, blood gases, and acid-base balance were evaluated at different levels of hypothermia and during recovery. Results: Fetal survival was related to maternal hypothermia: all group A fetuses survived, while 2 of 4 fetuses of group B in which maternal temperature was lowered below 18°C died in a very deep acidotic and hypoxic status. Maternal temperature was always lower than fetal temperature during cooling; during rewarming the gradient was inverted. The start of cardiopulmonary bypass and cooling was associated with transient fetal tachycardia and hypertension; then, both fetal heart rate and blood pressure progressively decreased. The reduction of fetal heart rate was of 7 beats per minute for each degree of fetal cooling. Deep maternal hypothermia was associated with fetal alkalosis and reduction of PO 2. Very deep hypothermia, in particular below 18°C, caused irreversible fetal acidosis and hypoxia. Conclusions: Deep maternal hypothermic cardiopulmonary bypass was associated with reversible modifications in fetal cardiovascular parameters, blood gases, and acid-base balance and therefore with fetal survival. On the contrary, fetuses did not survive to a very deep hypothermia below 18°C.
UR - http://www.scopus.com/inward/record.url?scp=2642559669&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=2642559669&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2003.08.036
DO - 10.1016/j.jtcvs.2003.08.036
M3 - Article
C2 - 15173730
AN - SCOPUS:2642559669
VL - 127
SP - 1728
EP - 1734
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 6
ER -