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

Shahar Bar-Yosef, Joseph P. Mathew, Mark F. Newman, Kevin P. Landolfo, Hilary P. Grocott

Research output: Contribution to journalArticle

30 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)641-646
Number of pages6
JournalAnesthesia and Analgesia
Volume99
Issue number3
DOIs
StatePublished - Sep 2004
Externally publishedYes

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Rewarming
Feasibility Studies
Thoracic Surgery
Fever
Cardiopulmonary Bypass
Hypothermia
Temperature
Coronary Artery Bypass
Neck
Solar System
Body Temperature
Prospective Studies

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 journalArticle

Bar-Yosef, Shahar ; Mathew, Joseph P. ; Newman, Mark F. ; Landolfo, Kevin P. ; Grocott, Hilary P. / Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming combination with post-bypass body surface warming : A feasibility study. In: Anesthesia and Analgesia. 2004 ; Vol. 99, No. 3. pp. 641-646.
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