Cardiovascular effects of induced hypothermia after lung transplantation

Background. Induced hypothermia may be used to reduce metabolism in acute r espiratory failure. Hypothermia is accompanied by an increase in pulmonary vascular resistance, as also seen in the early period after lung transplant ation. II was our concern that the combination of the two would lead to an increased workload on the right ventricle. Methods. To test this hypothesis we induced hypothermia to 32 degrees C in two groups of pigs. In one group we performed left single-lung transplantat ion combined with right pulmectomy (TRANSP group); in the other group, only right pulmectomy was performed (PULMEC group). Results. During hypothermia, there was a significant increase in both group s in pulmonary vascular resistance (TRANSP group, 77%, p < 0.05; PULMEC gro up, 54%, p < 0.05) and a significant decrease in cardiac output (TRANSP gro up, 41%, p < 0.05; PULMEC group, 34% p < 0.05). Mean pulmonary artery press ure was unchanged, and the work done by the right ventricle was reduced (TR ANSP group, 39%, p < 0.05; PULMEC group, 31%). Conclusions. Induced hypothermia to 32 degrees C after lung transplantation resulted in a significant decrease in the work done by the right ventricle despite a significant increase in pulmonary vascular resistance. (Ann Thor ac Surg 1999;67:804-9) (C) 1999 by The Society of Thoracic Surgeons.