Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming in combination with post-bypass body surface warming: a feasibility study.

Published

Journal Article

Cerebral hyperthermia is common during the rewarming phase of cardiopulmonary bypass (CPB) and is implicated in CPB-associated neurocognitive dysfunction. Limiting rewarming may prevent cerebral hyperthermia but risks postoperative hypothermia. In a prospective, controlled study, we tested whether using a surface-warming device could allow limited rewarming from hypothermic CPB while avoiding prolonged postoperative hypothermia (core body temperature <36 degrees C). Thirteen patients undergoing primary elective coronary artery bypass grafting surgery were randomized to either a surface-rewarming group (using the Arctic Sun thermoregulatory system; n = 7) or a control standard rewarming group (n = 6). During rewarming from CPB, the control group was warmed to a nasopharyngeal temperature of 37 degrees C, whereas the surface-warming group was warmed to 35 degrees C, and then slowly rewarmed to 36.8 degrees C over the ensuing 4 h. Cerebral temperature was measured using a jugular bulb thermistor. Nasopharyngeal temperatures were lower in the surface-rewarming group at the end of CPB but not 4 h after surgery. Peak jugular bulb temperatures during the rewarming phase were significantly lower in the surface-rewarming group (36.4 degrees C +/- 1 degrees C) compared with controls (37.7 degrees C +/- 0.5 degrees C; P = 0.024). We conclude that limiting rewarming during CPB, when used in combination with surface warming, can prevent cerebral hyperthermia while minimizing the risk of postoperative hypothermia[corrected].

Full Text

Duke Authors

Cited Authors

  • Bar-Yosef, S; Mathew, JP; Newman, MF; Landolfo, KP; Grocott, HP; Neurological Outcome Research Group, ; C A R E Investigators of the Duke Heart Center,

Published Date

  • September 2004

Published In

Volume / Issue

  • 99 / 3

Start / End Page

  • 641 - 646

PubMed ID

  • 15333386

Pubmed Central ID

  • 15333386

International Standard Serial Number (ISSN)

  • 0003-2999

Digital Object Identifier (DOI)

  • 10.1213/01.ANE.0000130354.90659.63

Language

  • eng

Conference Location

  • United States