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Cooling in Surgical Patients: Two Case Reports

机译：手术患者降温：两例报告

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Moderate induced hypothermia has become standard of care for children with peripartum hypoxic ischaemic encephalopathy. However, children with congenital abnormalities and conditions requiring surgical intervention have been excluded from randomised controlled trials investigating this, in view of concerns regarding the potential side effects of cooling that can affect surgery. We report two cases of children, born with congenital conditions requiring surgery, who were successfully cooled and stabilised medically before undergoing surgery. Our first patient was diagnosed after birth with duodenal atresia after prolonged resuscitation, while the second had an antenatal diagnosis of left-sided congenital diaphragmatic hernia and suffered an episode of hypoxia at birth. They both met the criteria for cooling and after weighing the pros and cons, this was initiated. Both patients were medically stabilised and successfully underwent therapeutic hypothermia. Potential complications were investigated for and treated as required before they both underwent surgery successfully. We review the potential side effects of cooling, especially regarding coagulation defects. We conclude that newborns with conditions requiring surgery need not be excluded from therapeutic hypothermia if they might benefit from it.
机译：中度诱发体温过低已成为围产期缺氧缺血性脑病患儿的治疗标准。但是，考虑到冷却可能影响手术的潜在副作用，对具有先天性异常和需要手术干预的状况的儿童进行调查的随机对照试验已将其排除在外。我们报告了两例先天性疾病需要手术的儿童，他们在手术前已成功地冷却并稳定下来。我们的第一例患者在出生后经长期复苏后被诊断为十二指肠闭锁，而第二例患者在产前诊断为左侧先天性diaphragm肌疝并在出生时出现缺氧。他们俩都符合冷却标准，在权衡利弊之后，就开始了。两名患者均在医学上稳定下来，并成功接受了低温治疗。在成功进行手术之前，对潜在的并发症进行了调查并根据需要进行了治疗。我们回顾了冷却的潜在副作用，尤其是在凝结缺陷方面。我们得出的结论是，如果有条件的新生儿可能需要手术治疗，则不必将其排除在治疗性低温治疗之外。

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