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September 17, 1960

Safe HypothermiaA Report on the Use of External Ice-Baths in Open Heart Surgery on One Hundred Patients

JAMA. 1960;174(3):284-286. doi:10.1001/jama.1960.03030030064012

The authors report on the first 100 of a series of patients who have undergone open heart surgery while in a state of hypothermia induced by external ice-baths. Circulatory occlusion was maintained as long as 15 minutes at rectal temperatures of 26° to 28° C. by removing the carbon dioxide absorber from the respiratory circuit and allowing the CO2 to accumulate up to concentrations of 3 to 5%. Above 28° C. ventricular fibrillation occurred 12 times in hyperventilated patients; below 28° C., with added CO2, no fibrillation occurred. Heart failure occurred in 3 of 65 patients who were digitalized and in 24 of 35 patients who were not. No complications occurred during induction of hypothermia or during the subsequent rewarming.