Determinants of postoperative hypothermia after normothermic cardiopulmonary bypass.
Inadvertent postoperative hypothermia in the cardiac surgical patient can have various adverse physiologic effects. Previous studies have investigated the relationship of patient, surgical, and anesthetic factors with postoperative hypothermia in patients undergoing noncardiac surgery. This study was designed to assess the relationship between postoperative hypothermia after normothermic cardiopulmonary bypass (CPB) for cardiac surgery and a variety of perioperative and patient factors. Fifty-six patients undergoing daytime elective or urgent cardiac surgery with warm (37 degrees C) CPB were studied. The following patient variables were included: age, weight, height, sex, history of previous cardiac surgery, and prebypass temperature. The following treatment factors were recorded: type of surgery, type and dose of anesthetic, use of airway humidifier, use of an intravenous (i.v.) fluid warmer, total volume of i.v. fluid administered during surgery, net fluid volume administered via CPB, total time spent on CPB, use of nitroglycerin, use of alpha-agonists during surgery, and elapsed time from end of CPB to end of surgery. Core temperature readings, as measured by a pulmonary artery catheter thermistor, were noted as follows: (1) on insertion of the pulmonary artery catheter; (2) after the patient was weaned from CPB; (3) within 30 minutes of intensive care unit (ICU) arrival; (4) 3 to 5 hours after ICU arrival; (5) 7 to 9 hours after ICU arrival; and (6) 11 to 13 hours after ICU arrival. Multiple linear regression and logistic regression for categorical variables with backward elimination were employed to determine the impact of all variables on lowest postoperative temperature. The lowest mean temperature occurred during CPB.(ABSTRACT TRUNCATED AT 250 WORDS)
Baker
J
J
Department of Anaesthesia, St Michael's Hospital, Toronto, Ontario, Canada.
Baker
A J
AJ
Mazer
C D
CD
D000367:Age Factors; D000768:Anesthesia, General; D001831:Body Temperature; D001835:Body Weight; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods; D003422:Critical Care; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007035:Hypothermia / Q000209:etiology*; D007430:Intraoperative Care; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D012737:Sex Factors; D013821:Thermometers; D013997:Time Factors