• John G Augoustides, Thomas F Floyd, Michael L McGarvey, E Andrew Ochroch, Alberto Pochettino, Shelly Fulford, Andrew J Gambone, Justin Weiner, Sushma Raman, Joseph S Savino, Joseph E Bavaria, and David R Jobes.
• Department of Anesthesia, Cardiothoracic Section, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA. yiandoc@hotmail.com
• J. Cardiothorac. Vasc. Anesth. 2005 Aug 1;19(4):446-52.

ObjectiveThe purpose of this study was to describe clinical outcome after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA), to determine mortality and length of stay, neurologic outcome, cardiorespiratory outcome, and hemostatic and renal outcome after DHCA.DesignRetrospective and observational.SettingCardiothoracic operating rooms and intensive care unit (ICU).ParticipantsAll adults requiring thoracic aortic repair with DHCA.InterventionsNone. The study was observational.Main ResultsThe cohort size was 110. All patients received an antifibrinolytic. The mortality rate was 8.2%. The mean length of stay was 6.8 days (ICU) and 14.0 days (hospital). The incidence of stroke was 8.1% and postoperative delirium was 10.9%. The rate of postoperative atrial fibrillation was 43.6%; 19.1% required postoperative mechanical ventilation longer than 72 hours. Chest tube drainage was 931 mL for the first 24 hours. Postoperative dialysis was required in 1.8% of patients. Renal dysfunction occurred in 40% to 50% of patients, depending on the definition.ConclusionsThe protocol for DHCA at the authors' institution is associated with superior or equivalent perioperative outcomes to those reported in the literature. This study identified the need for further quantification of the clinical outcomes after DHCA in order to prioritize outcome-based hypothesis-driven prospective intervention in DHCA.

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