Moderate hypothermic versus normothermic total cardiopulmonary bypass for coronary artery surgery: a retrospective study.
A retrospective analysis of 200 patients who underwent coronary artery bypass surgery between 1987 and 1990 was performed to ascertain whether there was any difference in morbidity or mortality with normothermic versus moderate hypothermic perfusion. Total cardiopulmonary bypass was used in all patients. 100 patients (Group H) were perfused using moderate (28-32 degrees C) hypothermia and the remaining 100 patients (Group N) were perfused at normothermia (37 degrees C). Both groups were comparable for age, weight, BSA, and perfusion time (Group H-mean 64 years, 82 Kg., 1.92 m2, 94 minutes; Group N-mean 63 years, 82 Kg., 1.90 m2, 90 minutes). Mean perfusate temperature in Group H was 31 degrees C, while the normothermic group was maintained at 37 degrees C. Both groups were perfused to maintain a venous oxygen saturation between 65-70 percent and arterial pressure between 60-70 mmHg. The cardiac index during bypass for Group H was lower (2.32 +/- .19 L/m2/min) than Group N (2.55 +/- .11 L/m2/min) (p less than 0.001). Mean arterial pressure for Group H was 69 +/- 12.4 mmHg and for Group N was 63 +/- 7.8 mmHg (p less than 0.001). Oxygen transfer for Group N (159 +/- 43 cc/min) was higher than Group H (113 + 31cc/min) (p less than .001). Metabolic acidosis was not observed in either group. Group H required vasodilators while Group N required vasoconstriction to maintain pressures on total bypass between 60-70 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)
Division of Cardiovascular Surgery, Brown University Program in Medicine, Providence, Rhode Island.
R J
RJ
Massimino
G T
GT
Stearns
J D
JD
Gough
J
J
Martin
A K
AK
Singh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002314:Cardioplegic Solutions / Q000008:administration & dosage; D002315:Cardiopulmonary Bypass / Q000379:methods*; D001026:Coronary Artery Bypass; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies