[The comparison of tepid and moderate hypothermic cardiopulmonary bypass in cardiac surgery].
Normothermic cardiopulmonary bypass (CPB) is being increasingly used at some institutions. Patients undergoing normothermic CPB have a higher systemic oxygen demand and may be at higher risk for ischemic injury. This study was designed to confirm the clinical efficacy and safety of tepid hypothermic CPB. Thirty-six patients undergoing open heart surgery between June 1993 and August 1994 were divided into two groups: tepid (n = 18, 32 degrees C) and moderate (n = 18, 26 degrees C) hypothermic CPB. There were no significant differences in preoperative and perioperative patients characteristics between the two groups. The mean aortic cross-clamp time did not differ between two groups, but the mean CPB time was significantly shorter in tepid hypothermic patients. Serum lactate after CPB and lactate/pyrvate ratio during CPB in tepid hypothermic patients were significantly lower than in moderate hypothermic patients. The mixed venous oxygen saturation in tepid hypothermic patients was significantly lower however, it was maintained at levels more than 70% during CPB. This study suggests that tepid hypothermic CPB is a safe and effective alternative to moderate hypothermic CPB for patients undergoing open heart surgery. Previous reports have documented that patients undergoing normothermic CPB are at greater risk for cerebral desaturation. We should evaluate cerebral venous oxygen saturation during tepid hypothermic CPB before the induction of normothermic CPB.
Kiyama
H
H
Department of Cardiovascular and Thoracic Surgery, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Ohshima
N
N
Hata
I
I
Satoh
Y
Y
Murai
N
N
Katayama
Y
Y
Irie
Y
Y
Imazeki
T
T
Yamada
T
T
D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006801:Humans; D007773:Lactates / Q000097:blood; D010100:Oxygen / Q000097:blood; D011773:Pyruvates / Q000097:blood; D013696:Temperature
D007773:Lactates; D011773:Pyruvates; D010100:Oxygen