Normothermia versus hypothermia during cardiopulmonary bypass: a randomized, controlled trial

Détails

ID Serval
serval:BIB_BB4261696184
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Normothermia versus hypothermia during cardiopulmonary bypass: a randomized, controlled trial
Périodique
Annals of Thoracic Surgery
Auteur⸱e⸱s
Tonz  M., Mihaljevic  T., von Segesser  L. K., Schmid  E. R., Joller-Jemelka  H. I., Pei  P., Turina  M. I.
ISSN
0003-4975
Statut éditorial
Publié
Date de publication
01/1995
Peer-reviewed
Oui
Volume
59
Numéro
1
Pages
137-143
Notes
Clinical Trial Comparative Study Journal Article Randomized Controlled Trial --- Old month value: Jan
Résumé
To evaluate the influence of perfusion temperature on systemic effects of cardiopulmonary bypass (CPB), 30 patients undergoing elective coronary artery bypass grafting were randomly assigned to either normothermic (warm, n = 14, 36 degrees C) or hypothermic (cold, n = 16, 28 degrees C) CPB. Serial hemodynamic measurements and blood samples were obtained before, during and after the CPB procedure. During CPB, there were no differences between both groups in the need for vasopressors (norepinephrine, phenylephrine), urinary output, or fluid balance. In the early postoperative period, normothermic CPB patients had significantly lower systemic vascular resistance and higher cardiac index measurements (mean +/- standard error: systemic vascular resistance, 880 +/- 27 versus 1,060 +/- 57 dyne.s.cm-5, p = 0.025; cardiac index, 3.6 +/- 0.1 versus 2.9 +/- 0.1 L.min-1.m-2, p = 0.01) without differences in the administration of vasoactive drugs. Blood loss was significantly higher in patients after hypothermic CPB (median [range] body surface area: 370 [180-560] versus 490 [280-2,120] mL/m2, p = 0.0006), with a greater need for transfusion of erythrocytes and fresh frozen plasma. Plasma levels of tumor necrosis factor and soluble tumor necrosis factor receptors increased during and after CPB, independent of perfusion temperature. This study suggests a significant influence of CPB temperature and respective perfusion management on postoperative hemodynamics and blood loss. Normothermic CPB is not associated with additional systemic adverse effects.
Mots-clé
Blood Loss, Surgical Blood Transfusion Cardiopulmonary Bypass/*methods Coronary Artery Bypass Female Hemodynamics Humans Male Middle Aged Prospective Studies Receptors, Tumor Necrosis Factor/analysis Temperature Tumor Necrosis Factor-alpha/analysis
Pubmed
Web of science
Création de la notice
14/02/2008 14:18
Dernière modification de la notice
20/08/2019 15:29
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