MC CLAUGHRY 



hypothermia. They used both the external blanket procedure, 

 and they used extra-corporeal cooling of the blood via the heart- 

 lung machine, and they also told me about the experiences of 

 colleagues, Dr. Lewis from Chicago, and Dr. Duke and Dr. Swan 

 of Colorado, They told me that invariably what these individuals 

 in their own experiences encounter are physiological problems 

 in their patients; problems involving blood clotting dyscrasia, 

 cardiac arrhythmia, and so on. 



They lower the temperature of their patients down to as low 

 as 27° C using external blankets for six to thirteen minutes, 

 and use multiple exposures of this t3TDe in carrying out their 

 surgical procedures. Invariably, they were surprised when I 

 asked them about infectious disease, and the four I spoke to 

 all said, "Well, of course these patients are all covered by post- 

 operative antibiotic treatment," but in no case were they con- 

 cerned about postoperative infectious disease, I think you should 

 know about that. 



BLAIR: I am very much involved, in addition to my inter- 

 est in bacteremic problems, in surgery. The fact does remain 

 that we understand and know really very little about what hjqjo- 

 thermia does under these circumstances of altering the envi- 

 ronment of the bacteria. The University of Minnesota group 

 has been interested; Fisher at Pittsburgh has studied the ef- 

 fects of cold upon so-called host mechanisms. Whatever mecha- 

 nisms are concerned, we know that bacteria are cleared very 

 readily after injecting and introducing a tremendous number 

 of bacteria into the blood stream. Now, what this really means 

 from the standpoint of the added insult and stress of surgery, 

 anaesthesia and what-not, I don't know. However, purely from 

 the standpoint of the rather emperical criterion of the progress 

 of patients postoperatively, the incidence of infections post- 

 operatively after the use of hypothermia is related only to the 

 surgery. They have been traced without difficulty to errors and 

 faults with reference to techniques in surgery, which all sur- 

 geons should know a lot better about, of course. Infections have 

 also been traced to the machinery inusing extra- corporeal systems 

 of cooling. 



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