Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 695-709 , December 2008

Hypothermia during cardiac surgery

  • Juan-Manuel Campos (Consultant in Anaesthesia)

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +34 687 81 55 25; Fax: +34 93 291 92 64.
    • ,
  • Pilar Paniagua (Consultant in Anaesthesia)

References 

  1. DeFrances CJ & Hall MJ. National Hospital Discharge Survey. CDC Advance Data 2007. Atlanta, USA: U.S. Department of Health and Human Services, 2005. Available from: http://www.cdc.gov/nchs/data/ad/ad385.pdf.
  2. Cook DJ. Changing temperature management for cardiopulmonary bypass. Anesth Analg. 1999;88:1254–1271
  3. Metha AR, Romanoff ME, Licina MG. Anesthetic management in the precardiopulmonary bypass period. In:  Hensley FA,  Martin DE,  Gravlee GP editor. A practical approach to Cardiac Anesthesia. 4th edn.. Philadelphia: Lippincott Willians & Wilkins; 2008;p. 176–197
  4. Pestel GJ, Kurz A. Hypothermia – it's more than a toy. Curr Opin Anesthesiol. 2005;18:151–156
  5. Deakinn CD, Clewlow F, Pierce T. Thermal energy balance as a measure of adequate rewarming from hypothermic cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia. 2000;14:388–392
  6. Kurz A, Sessler DI, Lenhardt RA. Study of Wound Infections and Temperature Group. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. NEJM. 1996;334:1209–1215
  7. Boldt J, Knothe C, Zickmann B, et al. Platelet function in cardiac surgery: influence of temperature and aprotinin. Ann Thorac Surg. 1993;55:652–658
  8. Engelman RM, Pleet B, Rousou JA, et al. Influence of cardiopulmonary bypass perfusion temperature on neurologic and hematologic function after coronary artery bypass grafting. Ann Thorac Surg. 1999;67:1547–1556
  9. Honore PM, Jacquet LM, Beale RJ, et al. Effects of normothermia versus hypothermia on extravascular lung water and serum cytokines during cardiopulmonary bypass: a randomized, controlled trial. Crit Care Med. 2001;29:1903–1909
  10. Khatri P, Babyak P, Croughwell ND, et al. Temperature during coronary artery bypass surgery affects quality of life. Ann Thorac Surg. 2001;71:110–116
  11. Christakis GT, Koch JP, Deemar KA, et al. A randomized study of the systemic effects of warm heart surgery. Ann Thorac Surg. 1992;54:449–459
  12. Brown WM, Jay JL, Gott JP, et al. Warm blood cardioplegia: superior protection after acute myocardial ischemia. Ann Thorac Surg. 1993;55:32–41
  13. Woo YJ, Atluri P, Grand TJ, et al. Active thermoregulation improves outcome of off-pump coronary artery bypass. Asian Cardiovasc Thorac Ann. 2005;13:157–160
  14. Romlin B, Petruson K, Nilsson K. Moderate superficial hypothermia prolongs bleeding time in humans. Acta Anaesthesiol Scand. 2007;51:198–201
  15. Birdi I, Caputo CM, Angelini GD, et al. Influence of normothermic systemic perfusion temperature on cold myocardial protection during coronary artery bypass. Cardiovascular Surgery (London, England). 1999;7:369–374
  16. Engelman RM, Pleet AB, Hicks R, et al. Is there a relationship between systemic perfusion temperature during coronary artery bypass grafting and extent of intraoperative ischemic central nervous system injury?. The Journal of Thoracic and Cardiovascular Surgery. 2000;119:230–232
  17. Lavinio A, Timofeev I, Nortje J, et al. Cerebrovascular reactivity during hypothermia and rewarming. Br J Anaesth. 2007;99:237–244
  18. Insler SR, O'Connor MS, Leventhal MJ, et al. Association between postoperative hypothermia and adverse outcome after coronary artery bypass surgery. Ann Thorac Surg. 2000;70:175–181
  19. Nathan HJ, Parlea L, Dupuis JY, et al. Safety of deliberate intraoperative and postoperative hypothermia for patients undergoing coronary artery surgery: a randomized trial. J Thorac Cardiovasc Surg. 2004;127:1270–1275
  20. Heier T, Caldwell JE. Impact of hypothermia on the response to neuromuscular blocking drugs. Anesthesiology. 2006;104:1070–1080
  21. Roach GW, Kanchuguer M, Mangano CM, et al. Adverse cerebral outcomes after coronary bypass surgery. N Eng J Med. 1996;335:1857–1863
  22. Ali MS, Harmer M, Kirkham F. Cardiopulmonary bypass temperature and brain function. Anaesthesia. 2005;60:365–372
  23. Kadoi Y, Kawahara F, Saito S, et al. Effects of hypothermic and normothermic cardiopulmonary bypass on brain oxygenation. Ann Thorac Surg. 1999;68:34–39
  24. Shann KG, Likosky DS, Murkin JM, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: a focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J Thorac Cardiovasc Surg. 2006;132:283–290
  25. MacLean RF, Wong BI, Naylor CD, et al. Cardiopulmonary bypass temperature and central nervous system dysfunction. Circulation. 1994;90:II250–II255
  26. Nathan HJ, Wells GA, Munson JL, et al. Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass. Circulation. 2001;104:I85–I91
  27. Boodhwani M, Rubens FD, Wozny D, et al. Predictors of early neurocognitive deficits in low-risk patients undergoing on-pump coronary artery bypass surgery. Circulation. 2006;114(Suppl. 1):I461–I466
  28. Boodhwani M, Rubens F, Denise Wozny D, et al. Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery: a randomized, double-blind study. J Thorac Cardiovasc Surg. 2007;134:1443–1452
  29. DeFoe G, Krumholz C, DioDato C, et al. Lowest core body temperature and adverse outcomes associated with coronary artery bypass surgery. Perfusion. 2003;18:127–133
  30. Rees K, Beranek-Stanley M, Burke M, et al. Hypothermia to reduce neurological damage following coronary artery bypass surgery. Cochrane Database System Reviews. 2001;1:CD002138
  31. Kadoi Y, Goto F. Factors associated with postoperative cognitive dysfunction in patients undergoing cardiac surgery. Surg Today. 2006;36:1053–1057
  32. Ho PM, Arciniegas DB, Grigsby J, et al. Predictors of cognitive decline following coronary artery bypass graft surgery. Ann Thorac Surg. 2004;77:597–603
  33. Dupuis G, Kennedy E, Lindquist R, et al. Coronary artery bypass graft surgery and cognitive performance. Am J Crit Care. 2006;15:471–479
  34. Grigore AM, Grocott HP, Matthew JP, et al. The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery. Anesth Analg. 2002;94:4–10
  35. Kaukuntla H, Harrington D, Bilkoo I, et al. Temperature monitoring during cardiopulmonary bypass – do we undercool or overheat the brain?. Eur J Cardiothorac Surg. 2004;26:580–585
  36. Kawhara F, Kadoi Y, Goto F, et al. Slow rewarming improves jugular venous oxygen saturation during rewarming. Acta Anaesthesiol Scand. 2003;47:419–424
  37. Nesher N, Zisman Eli, Wolf T, et al. Strict thermoregulation attenuated myocardial injury during coronary artery bypass graft surgery as reflected by reduced levels of cardiac-specific troponin I. Anesth Analg. 2003;96:328–335
  38. Myron D, Ginsberg M, Busto R. Combating hyperthermia in acute stroke: a significant clinical concern. Stroke. 1998;29:529–534
  39. Nussmeier NA, Cheng W, Marino M, et al. Temperature during cardiopulmonary bypass: the discrepancies between monitored sites. Anesth Analg. 2006;103:1373–1379
  40. Bar-Yosef S, Mathew JP, Newman MF, et al. 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;99:641–646
  41. Puskas F, Grocott HP, White WD, et al. Intraoperative hyperglycemia and cognitive decline after CABG. Ann Thorac Surg. 2007;84:1467–1473
  42. Naughton C, Reilly N, Powroznyk A. Factors determining the duration of tracheal intubation in cardiac surgery: a single-centre sequential patient audit. Eur J Anaesthesiol. 2003;20:225–233
  43. Sessler DI. Heat preservation during cardiac surgery. J Cardiothorac Vasc Anesth. 2000;14:499–500
  44. Sessler DI. Hyperthermia after cardiac surgery: mechanism and importance. J Cardiothorac Vasc Anesth. 2005;19:423–425
  45. Grocott HP, Mackensen GB, Grigore AM, et al. Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery. Stroke. 2002;33:537–541
  46. Licker M, Schaweizer , Ralley FE. Thermoregulatory and metabolic responses following cardiac surgery. Eur J Anaesthesiol. 1996;13:502–510
  47. Parolari A, Alamanni F, Polvani G, et al. Meta-analysis of randomized trials comparing off-pump with on-pump coronary artery bypass. Ann Thorac Surg. 2005;80:2121–2125
  48. Cheng DC, Brainbridge D, Martin JE, et al. Does off-pump coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with conventional coronary artery bypass? A meta-analysis of randomized trials. Anesthesiology. 2005;102:188–203
  49. van der Heijden G, Nathoe H, Jansen E, et al. Meta-analysis on the effect of off-pump coronary bypass surgery. Eur J Cardiothorac Surg. 2004;26:81–84
  50. St. André AC, DelRossi A. Hemodynamic management of patients in the first 24 hours after cardiac surgery. Crit Care Med. 2005;33:2082–2093
  51. Stanley T, Grocott H, Phillips-Bute B, et al. Preliminary evaluation of the Arctic Sun temperature-controlling system during off-pump coronary artery bypass surgery. Ann Thorac Surg. 2003;75:1140–1144
  52. Vassiliades T, Nielsen J, Lonqquist J. Evaluation of a new temperature management system during off-pump coronary artery bypass. Interact CardioVasc Thorac Surg. 2003;2:454–457
  53. Nesher N, Wolf T, Kushnir I, et al. Novel thermoregulation system for enhancing cardiac function and hemodynamics during coronary artery bypass graft surgery. Ann Thorac Surg. 2001;72:S1069–S1076
  54. Kiessling AH, Isgro F, Lehmann A, et al. Evaluating a new method for maintaining body temperature during OPCAB and robotic procedures. Med Sci Monit. 2006;12:39–42
  55. Hofer CK, Worn M, Tavaloki R, et al. Influence of body core temperature on blood loss and transfusion requirements during off-pump coronary artery bypass grafting: a comparison of 3 warming systems. J Thorac Cardiovasc Surg. 2005;129:838–843
  56. Bräuer A, English MJ, Steinmetz N, et al. Efficacy of forced-air warming systems with full body blankets. Can J Anesth. 2007;54:34–41
  57. Wadhwa A, Komatsu R, Orhan-Sungur M, et al. New circulating-water devices warm more quickly than forced-air in volunteers. Anesth Analg. 2007;105:1681–1687
  58. Rajek A, Lenhardt R, Sessler DI, et al. Efficacy of two methods for reducing postbypass afterdrop. Anesthesiology. 2000;92:447–456
  59. Kim JY, Shinn H, Oh YJ, et al. The effect of skin surface warming during anesthesia preparation on preventing redistribution hypothermia in the early operative period of off-pump coronary artery bypass surgery. Eur J Cardiothorac Surg. 2006;29:343–347
  60. Immer FF, Ackermannn A, Cygax E, et al. Minimal extracorporeal circulation is a promising technique for coronary artery bypass grafting. Ann Thorac Surg. 2007;84:1515–1521
  61. Adams DH, Heyer EJ, Simon AE, et al. Incidence of atrial fibrillation after mild or moderate hypothermic cardiopulmonary bypass. Crit Care Med. 2000;28:309–311
  62. Creswell LL, Alexander JC, Ferguson TB, et al. Intraoperative interventions. American College of Chest Physicians Guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128:28S–35S
  63. Flynn K, Adams E, Alligood E. Optimal Temperature for Cardioplegia during Coronary Artery Bypass Grafting. Department of Veterans Affairs, 2003. Available from: http://www.va.gov/vatap/pubs/cardioplegia.pdf2003;
  64. Kapetanopoulos A, Katsetos MC, Kluger J. Intraoperative hypothermia increased defibrillation energy requirements. The Journal of Cardiovascular Medicine. 2007;8:741–743
  65. Stanley TO, Mackensen GB, Grocott HP, et al. The impact of postoperative atrial fibrillation on neurocognitive outcome after coronary artery bypass graft surgery. Anesth Analg. 2002;94:290–295
  66. Gega A, Rizzo JA, Johnson MH, et al. Straight deep hypothermic arrest: experience in 394 patients support its effectiveness as a sole mean of brain preservation. Ann Thorac Surg. 2007;84:759–767
  67. Griepp RB. Cerebral protection during aortic arch surgery. J Thorac Cardiovasc Surg. 2001;121:425–427
  68. Rajek A, Lenhardt R, Sessler DI, et al. Tissue heat content and distribution during and after cardiopulmonary bypass at 31°C and 27°C. Anesthesiology. 1998;88:1511–1518
  69. Rajek A, Lenhardt R, Sessler DI, et al. Tissue heat distribution during and after cardiopulmonary bypass at 17°C. Anesth Analg. 1999;88:1220–1225
  70. Peragallo RA, Cheng DCH. Tracheal extubation should not occur routinely in the operating room after cardiac surgery. J Cardiothorac Vasc Anesth. 2000;14:611–613
  71. Stensrud PE, Nuttall GA, de Castro M, et al. A prospective, randomized study of cardiopulmonary bypass temperature and blood transfusion. Ann Thorac Surg. 1999;66:711–715
  72. Tortorici MA, Kochanek PM, Poloyac SM. Effects of hypothermia on drug disposition, metabolism, and response: a focus of hypothermia-mediated alterations on the cytochrome P450 enzyme system. Crit Care Med. 2007;35:2196–2204
  73. ACC/AHA Pocket Guideline Coronary Artery Bypass Graft Surgery. In: Washington, DC: American College of Cardiology Foundation and American Heart Association, Inc; 2005;Available from: http://www.acc.org/qualityandscience/clinical/guidelines/cabg/index_pkt.pdf
  74. Scott EM, Buckland R. A systematic review of intraoperative warming to prevent postoperative complications. AORN J. 2006;83:1090–1113

PII: S1521-6896(08)00025-6

doi: 10.1016/j.bpa.2008.03.001

Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 4 , Pages 695-709 , December 2008

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