Artificial Hibernation: a Report of Forty-two Clinical Cases*

ON SEV-ZaAJ~ OCCASIONS the subject of Artificial Hibernation has been dtscussed before the Canadian Anaesthetists' Society by Dr. Fernando ]-Iudon of Quebec City. We thought, therefore, it would be of some interest to present a series of 42 climcal cases of which '22 were medical and 20 were surgic~d. From the concepts of Claude Berna~, Cannon, Reilly and Selye, Laborit evolved his technique of "Art2ficial Hibernation,'" by which he trans~Eorms a homeothermic organism to a ]?oikilothermic organism. Summarizing these two concepts, we can say that a homeothermic being is one who can maintain a constant internal environment in spite of a changing external environment. Under conditaons of severe stress the homeothermic state becomes a disadvantage because the expenditure of energy in maintaining this constancy will tend to exhaust the orgamsm and to hasten death. When an organ1sin approaches the poikilothermic sta! e, the constancy of the internal environment is partly sacrificed, energy is conserved, and life is prolonged. Labont concluded that art~cml hibernataon, utilizing the "lyric cocktail," could be a valuable means of maintmning life of patients in extrerni~. Our modest series of cases would seem to bear this out. There were patients whose hves were prolonged for periods as long as two month,,;. The series was dwided into lwo groups: first, the surgical, where hibernation was used only for flae period of surgery; and second, the medical, where this technique was employed as a resusc~tahve measure. Some of the patients of the second group went on to further treatment by surgery during the period of h~bernaUon. M ~ I c ~ CAs~.s (Table I) In our series of medical cases, 14 out of 22 patients were in extrernis; every conventional treatment had failed, and death was imminent. Six out of these fourteen patients represented cases of cerebro-vascular accidents associated with hyperthermia. All of them showed cliaieal improvement during hibernation. Four died upon emerging from hibernaeion; the other two died two months later. Post-mortem examinations demonstrated lesions incompatible with life in every case. Another five of these fourteen patmnts had severe head injuries and they were also in extremis when they were submitted to hibernation. All were operated[ on either before or during hibernation. Four out of the five did well and had complete recovery. The hibernation lasted from three to ten days depending upon the reaction of the patient to attempts at rewarming. The patient who died was a 68-year-old arterio-sclerotic male, who had c uite extensive and profuse subdural bleeding. This was on the fourth day of hi Jernation following an exploratory craniotomy.