Comparative Analysis Of The Liver Function Between Deep Hypothermic Anesthesia And Moderate Hypothermia Anesthesia After Cardiopulmonary Bypass With Aortic Dissection

Objective:Through the comparison of moderate hypothermia anesthesia(25 °C-32 ° C)and deep hypothermic(<25 ° C)anesthesia in patients with acute type A aortic dissection after liver function biochemical indicators of cardiopulmonary bypass.Analysis of the effects on liver function.Methods:A retrospective analysis of 130 patients with aortic dissection type A aortic arch replacement performed by the same physician from January2013 to January 2018 was performed.The selected patient is between35-65 years old and ASA grade IV-V.According to the nasopharyngeal temperature during cardiopulmonary bypass(CPB),they were randomly divided into two groups.The nasopharynx temperature <25℃was marked as deep hypothermia group(DH),and the nasopharyngeal temperature 25℃-32℃ was marked as moderate hypothermia group(MH).There are 65 people in each group.The preoperative general conditions,history of past illness,surgical methods,cardiopulmonary bypass time,interruption time,cooling time,rewarming time,myocardial ischemia time,visceral ischemic time,temperature at cessation of circulation.In the postoperative of DH group and MH group,AST and total bilirubin increased to varying degrees.The biochemical indicators of liver function in the DH group weresignificantly higher than those in the MH group,which had a greater impact on liver function.Results:There were no statistical differences in preoperative general conditions including age,gender,height and weight between the two groups.There was no statistical difference in past history including hypertension,diabetes,chronic obstructive pulmonary disease,smoking,and drinking.There were no statistical differences between the other procedures and temperature during the same period.The extracorporeal circulation time,stopping cycle time,cooling time and rewarming time of DH group were longer than those of MH group,and the difference was statistically significant.AST and total bilirubin increased in different degrees after DH and MH,and the difference was statistically significant.Compared with MH group,DH group had the highest ALT and TBIL in the DH group at 24 h after operation and the highest postoperative value.The difference was statistically significant.Conclusion:The results showed that liver injury was caused by low temperature anesthesia in patients with aortic dissection.Comparing the nasopharyngeal temperature of 25℃-32 ℃with the nasopharyngeal temperature of <25 ℃,the protective effect of moderate hypothermia anesthesia on the liver was significantly better than that of deep hypothermia anesthesia.Therefore,aortic dissection with moderate hypothermia anesthesia is not only safe and reliable,but also shortens the cooling and rewarming time,thereby shortening the operation time,improving the safety of the operation,and facilitating the postoperative recovery of the patient.