Hyperthermia during Cardiopumonary Bypass

Hyperthermia during Cardiopumonary Bypass 


Moderate-quality prospective studies have demonstrated that when rewarming on cardiopulmonary bypass (CPB), hyperthermia (core temperature >37.9°C) is associated with cognitive deficits, infection, and renal dysfunction. Any postoperative hyperthermia within 24 hours after coronary artery bypass grafting has been associated with cognitive dysfunction at 4 to 6 weeks. Rewarming on CPB to normothermia should be combined with continuous surface warming. Thus, we recommend avoiding hyperthermia while rewarming on cardiopulmonary bypass (class III, level B-R).

Source:  Jama


1.
Grocott  HP, Mackensen  GB, Grigore  AM,  et al; Neurologic Outcome Research Group (NORG); Cardiothoracic Anesthesiology Research Endeavors (CARE) Investigators’ of the Duke Heart Center.  Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery.  Stroke. 2002;33(2):537-541. doi:10.1161/hs0202.102600PubMedGoogle ScholarCrossref
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Groom  RC, Rassias  AJ, Cormack  JE,  et al; Northern New England Cardiovascular Disease Study Group.  Highest core temperature during cardiopulmonary bypass and rate of mediastinitis.  Perfusion. 2004;19(2):119-125. doi:10.1191/0267659104pf731oaPubMedGoogle ScholarCrossref
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Newland  RF, Baker  RA, Mazzone  AL, Quinn  SS, Chew  DP; Perfusion Downunder Collaboration.  Rewarming temperature during cardiopulmonary bypass and acute kidney injury: a multicenter analysis.  Ann Thorac Surg. 2016;101(5):1655-1662. doi:10.1016/j.athoracsur.2016.01.086PubMedGoogle ScholarCrossref
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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.  Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming in combination with post-bypass body surface warming: a feasibility study.  Anesth Analg. 2004;99(3):641-646. doi:10.1213/01.ANE.0000130354.90659.63PubMedGoogle ScholarCrossref

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