Artificial Hibernation

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ARTIFICIAL hibernation has been used at the Cleveland Clinic Hospital only as a last resort in the treatment of extremely ill patients. Its status is that of adjunctive, not specific, therapy. In 1955, Kolff1 reported nine patients in whom the chief indications for hibernation were hyperpyrexia, uncontrollable deterioration, uncontrollable fall in blood pressure, ileus with severe distention, convulsions, extreme restlessness, coma, and cyanosis. After artificial hibernation, beneficial effects were evident, though there were no long-term survivors. Black and Kolff2 recently reported the cases of two patients whose recovery was helped by hibernation. A gratifying result in one patient was the cessation of gastrointestinal hemorrhage from a stress ulcer.

This study presents reports of three additional patients, in order to illustrate the current use of artificial hibernation. Two of the patients were also treated with hemodialysis. Because it has been described in detail previously,1,2 the technic, which is based on that of Laborit, Huguenard, and others,3 will not be discussed.

Case Reports

Case 1. A 58-year-old man underwent operation at the Cleveland Clinic Hospital for removal of a large substernal nodular goiter and a left carotid body tumor. Insertion of a left internal carotid artery (freeze-dried) homograft was required. Postoperatively, the patient had right flaccid hemiplegia and remained comatose. The endotracheal tube that had been inserted at the time of operation had to be left in place. In the hope of preventing further brain damage, artificial hibernation was instituted in the recovery room by maintaining the rectal temperature between 86 and . . .