Phrenic nerve is affected by hypothermia during open heart surgery

The aim : Our aim is to evaluate the benefit of this treatment method preventing the phrenic nerve injury because of the local hypothermia used for myocardial protection during the open heart surgery.Material and methods : 40 patients have been investigated in seperately, control (first) and study ( second ) group . In each group there were 20 patient. İn the first group of patients we did not use the cardiac isulation pad ( CİP) during the operation but in the second group we used the cardiac isulation pad. The total hypothermia was the same for all patients and it was +30 0C. All patients have been examined by the chest x-ray and spirometer before the operation, after operation and after 6 week of discharging from the hospital. The minimal or doubtful (uncertain ) changes on diaphragm were accepted normally.Result : The diaphragma elevation in control group was 16 patient isolated left side and 3 patient isolated right side, in study group there was no patient with the elevation. The elevation generally was left side. The difference in the incidence of diaphragmatic elevation between these two groups is statistically significant ( p .000 ). The spirometer results were statistical significant. In both group proportion of postoperative FVC to preoperative FVC were significant( p ,003). But in spite of decreasing of FEV1/FVC proportion after the operation results were not statistical significant. In this study we have found that by using the cardiac insulation pad we could protect phrenic nerve from the effect of the ice slush cooling.We can decide from this study that protection phrenic nerve by the cardiac insolution pad from the topical cooling can decrease the situation of diaphragm elevation and atelectasis.Conclusion: İn this study we have concluded that this complications can be prevented or reduced by the use of a CİP prior to the use of topical hypotermia. For cardiac insalution from ice slush we have used a glove which had a tampon inside. This method is the cheaper than the other prepared pads. The preparation of this pad is the simple and not need special technology.