The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base baance

Giorgio Pardi, Maria M. Ferrari, Fiore Iorio, Fabio Acocella, Veronica Boero, Nicola Berlanda, Ario Monaco, Claudio Reato, Francesco Santoro, Irene Cetin

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1728-1734
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume127
Issue number6
DOIs
Publication statusPublished - Jun 2004

Fingerprint

Cardiopulmonary Bypass
Hypothermia
Hemodynamics
Mothers
Temperature
Acids
Rewarming
Fetal Heart Rate
Fetus
Acid-Base Equilibrium
Gases
Multifetal Pregnancy Reduction
Fetal Hypoxia
Blood Pressure
Alkalosis
Acidosis
Fetal Blood
Tachycardia
Electrocardiography
Heart Rate

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 journalArticle

Pardi, Giorgio ; Ferrari, Maria M. ; Iorio, Fiore ; Acocella, Fabio ; Boero, Veronica ; Berlanda, Nicola ; Monaco, Ario ; Reato, Claudio ; Santoro, Francesco ; Cetin, Irene. / The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base baance. In: Journal of Thoracic and Cardiovascular Surgery. 2004 ; Vol. 127, No. 6. pp. 1728-1734.
@article{e25897a5b4164ca995a5b10a4aa92edc,
title = "The effect of maternal hypothermic cardiopulmonary bypass on fetal lamb temperature, hemodynamics, oxygenation, and acid-base baance",
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.",
author = "Giorgio Pardi and Ferrari, {Maria M.} and Fiore Iorio and Fabio Acocella and Veronica Boero and Nicola Berlanda and Ario Monaco and Claudio Reato and Francesco Santoro and Irene Cetin",
year = "2004",
month = "6",
doi = "10.1016/j.jtcvs.2003.08.036",
language = "English",
volume = "127",
pages = "1728--1734",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "6",

}

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 -