Advances in Low-Temperature Biology, Volume 3 by Peter L. Steponkus

By Peter L. Steponkus

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This was effective in allowing greater control of fluid balance during blood/substitute and substitute/substitute exchanges in the procedure, thereby avoiding fluid overload and associated problems during postoperative recovery. Fourteen adult mongrel dogs were anesthetized and cannulated to establish extracorporeal cardiac bypass. Initially surface cooling was employed and exsanguination was started at near 25°C. In 11 dogs (experimental group. Group I) Hypothermic Protection During Bloodless Surgery 35 Temperature Profile and Perfusion Schedule Group I Blood P M Blood |P 1 Group II 40 P M M P Blood P P "p" Blood 1 1 L 35 o o $.

1991; Robinson and Harwood, 1991). Some glucose is included in these hypothermic solutions as a substrate, but the concentration is low to prevent exogenous overload during hypothermia. , 1992). Acidosis is a particular hazard during hypothermia and attention has been given to the inclusion of a pH buffer that will be effective under non-physiological conditions that prevail at low temperatures. , 1989). Synthetic zwitterionic buffers such as HEPES also contribute to osmotic support in the extracellular compartment by virtue of their molecular size (HEPES = 238 daltons).

1993). Retention of the colloid in the vascular space is an important consideration for achieving optimal oncotic support, and in the context of isolated organ perfusion over several days, other colloids might be preferred to dextran-40. J. M. E. BAILES ferent colloids may be of less importance than other qualities, and non-antigenic clinical grade dextran-40 is used in Hypothermosol for the reasons outlined above. Any dextran that should permeate into the interstitial space during the hypothermic procedure will also be readily eluted upon return to physiological conditions.

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