TY - CHAP M1 - Book, Section TI - Chapter 14. Deep Hypothermic Circulatory Arrest A1 - Bardissi, Andrew W. El A1 - Oakes, Robert A. A1 - Bolman III, R. Morton A2 - Cohn, Lawrence H. PY - 2012 T2 - Cardiac Surgery in the Adult, 4e AB - Deep hypothermic circulatory arrest (DHCA) came about as an extension and unification of the work being done in the 1950s in cardiopulmonary bypass (Gibbon), systemic hypothermia (Bigelow), and aortic surgery (Debakey, Cooley, Crawford). Successful intracardiac surgery was based on the use of cardiopulmonary bypass (CPB); however, some procedures (eg, aortic arch surgery) could not be performed with standard CPB cannulation because of an inability to perfuse the cerebrum. Bigelow's work in the animal lab demonstrated that moderate hypothermia could be protective in cases in which CPB was halted for up to 10 minutes.1 The earliest use of DHCA in adult cardiac surgery has been accredited to Niazi and Lewis in 1958.2 Initially, DHCA was performed topically without the assistance of CPB; however, it soon became apparent that at hypothermic temperatures the heart would fibrillate or slow to a stop. Rewarming also proved to be quite difficult because of poor circulatory function during hypothermia. Many of these issues were improved on with the coordination of CPB with DHCA by the physiologist Gollan and the continued development and improvement of pump oxygenators and heat exchangers.3 Extensive work on the metabolic aspects of DHCA were studied and put into clinical practice by Griepp and others in the 1970s, leading to safe and reliable techniques that have been adopted by many into general practice. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=55914830 ER -