Cardiovascular effects of induced hypothermia after lung transplantation

Background. Induced hypothermia may be used to reduce metabolism in acute respiratory failure. Hypothermia is accompanied by an increase in pulmonary vascular resistance, as also seen in the early period after lung transplantation. It 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°C in two groups of pigs. In one group we performed left single-lung transplantation 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 groups in pulmonary vascular resistance (TRANSP group, 77%, p< 0.05; PULMEC group, 54%, p< 0.05) and a significant decrease in cardiac output (TRANSP group, 41%, p< 0.05; PULMEC group, 34% p< 0.05). Mean pulmonary artery pressure was unchanged, and the work done by the right ventricle was reduced (TRANSP group, 39%, p< 0.05; PULMEC group, 31%). Conclusions. Induced hypothermia to 32°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.