Deep hypothermic circulatory arrest
Surgical technique using deep hypothermia / From Wikipedia, the free encyclopedia
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Deep hypothermic circulatory arrest (DHCA) is a surgical technique in which the temperature of the body falls significantly (between 20 °C (68 °F) to 25 °C (77 °F)) and blood circulation is stopped for up to one hour. It is used when blood circulation to the brain must be stopped because of delicate surgery within the brain, or because of surgery on large blood vessels that lead to or from the brain. DHCA is used to provide a better visual field during surgery due to the cessation of blood flow.[1] DHCA is a form of carefully managed clinical death in which heartbeat and all brain activity cease.
When blood circulation stops at normal body temperature (37 °C), permanent damage occurs in only a few minutes. More damage occurs after circulation is restored. Reducing body temperature extends the time interval that such stoppage can be survived.[2] At a brain temperature of 14 °C, blood circulation can be safely stopped for 30 to 40 minutes.[3] There is an increased incidence of brain injury at times longer than 40 minutes, but sometimes circulatory arrest for up to 60 minutes is used if life-saving surgery requires it.[4][5] Infants tolerate longer periods of DHCA than adults.[6]
Applications of DHCA include repairs of the aortic arch, repairs to head and neck great vessels, repair of large cerebral aneurysms, repair of cerebral arteriovenous malformations, pulmonary thromboendarterectomy, and resection of tumors that have invaded the vena cava.[7][2]