Abstract
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°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°C, whereas the surface-warming group was warmed to 35°C, and then slowly rewarmed to 36.8°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°C ± 1°C) compared with controls (37.7°C ± 0.5°C; P = 0.024). We conclude that limiting rewarming during CPB, when used in combination with surface warming, can prevent cerebral hypothermia while minimizing the risk of postoperative hypothermia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 641-646 |
| Number of pages | 6 |
| Journal | Anesthesia and Analgesia |
| Volume | 99 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 2004 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
Cite this
Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming combination with post-bypass body surface warming : A feasibility study. / Bar-Yosef, Shahar; Mathew, Joseph P.; Newman, Mark F.; Landolfo, Kevin P.; Grocott, Hilary P.
In: Anesthesia and Analgesia, Vol. 99, No. 3, 09.2004, p. 641-646.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming combination with post-bypass body surface warming
T2 - A feasibility study
AU - Bar-Yosef, Shahar
AU - Mathew, Joseph P.
AU - Newman, Mark F.
AU - Landolfo, Kevin P.
AU - Grocott, Hilary P.
PY - 2004/9
Y1 - 2004/9
N2 - 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°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°C, whereas the surface-warming group was warmed to 35°C, and then slowly rewarmed to 36.8°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°C ± 1°C) compared with controls (37.7°C ± 0.5°C; P = 0.024). We conclude that limiting rewarming during CPB, when used in combination with surface warming, can prevent cerebral hypothermia while minimizing the risk of postoperative hypothermia.
AB - 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°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°C, whereas the surface-warming group was warmed to 35°C, and then slowly rewarmed to 36.8°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°C ± 1°C) compared with controls (37.7°C ± 0.5°C; P = 0.024). We conclude that limiting rewarming during CPB, when used in combination with surface warming, can prevent cerebral hypothermia while minimizing the risk of postoperative hypothermia.
UR - http://www.scopus.com/inward/record.url?scp=4143132297&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=4143132297&partnerID=8YFLogxK
U2 - 10.1213/01.ANE.0000130354.90659.63
DO - 10.1213/01.ANE.0000130354.90659.63
M3 - Article
C2 - 15333386
AN - SCOPUS:4143132297
VL - 99
SP - 641
EP - 646
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 3
ER -