Effect of temperature during cardiopulmonary bypass on gastric mucosal perfusion.

Journal Article (Clinical Trial;Journal Article)

The purpose of our study was to prospectively study the splanchnic response to hypothermic and tepid cardiopulmonary bypass (CPB) using alphastat management of arterial blood-gas tensions. Twenty-four patients for elective CABG surgery were allocated randomly to tepid (35-36 degrees C) or hypothermic (30 degrees C) bypass groups. Measurements were made at four times: (1) baseline, (2) stable during CPB (inflow temperature = nasopharyngeal temperature) 30 degrees C for hypothermic patients, bypass +20 min for tepid patients, (3) 10 min before the end of bypass, (4) after bypass, skin closure. Both groups demonstrated a significant reduction in gastric intramucosal pH (pHim) from time 1 to time 4 and there was no difference in the incidence of a low pHim between the tepid and cold groups (4/12 vs 3/12; ns) at time 4. pHim was significantly lower in the tepid groups at time 3 (P = 0.03) but this discrepancy may have been because of an artefactually high pHim in the cold group. There was a significantly higher incidence of postoperative non-cardiac complications in patients who had a low pHim at time 4 (P = 0.0008). Therefore, we conclude that although the temperature during CPB had a transient effect on pHim it is unlikely to be a major determinant in the pathogenesis of gut mucosal hypoperfusion after bypass.

Full Text

Duke Authors

Cited Authors

  • Croughwell, ND; Newman, MF; Lowry, E; Davis, RD; Landolfo, KP; White, WD; Kirchner, JL; Mythen, MG

Published Date

  • January 1997

Published In

Volume / Issue

  • 78 / 1

Start / End Page

  • 34 - 38

PubMed ID

  • 9059201

International Standard Serial Number (ISSN)

  • 0007-0912

Digital Object Identifier (DOI)

  • 10.1093/bja/78.1.34


  • eng

Conference Location

  • England