Normothermic versus hypothermic cardiopulmonary bypass during repair of congenital heart disease.
OBJECTIVE
To compare normothermic cardiopulmonary bypass (CPB) versus hypothermic CPB in pediatric patients undergoing repair of congenital heart disease with focus on biochemical markers for brain damage.


METHODS
Prospective randomized interventional study.


METHODS
Postgraduate teaching hospital.


METHODS
Twenty patients undergoing repair of congenital heart disease.


METHODS
Patients were randomized to normothermic (36 degrees C) versus hypothermic (25 degrees C) CPB. Serum levels of neuron-specific enolase (NSE) and S-100beta protein were measured in all patients before surgery, immediately after CPB, and 12 and 24 hours after surgery. Blood loss and time for extubation of the trachea were recorded.


RESULTS
Before operation, the S-100beta protein and NSE levels were similar in the 2 groups. The S-100beta protein serum level increased significantly after CPB in both groups, whereas no change was found in the NSE level. There was no difference in the change of NSE and S-100beta protein levels between normothermic and hypothermic CPB. Blood loss was significantly less after hypothermic CPB (25 mL/kg/24 h v 42 mL/kg/24 h). Time for extubation was similar.


CONCLUSIONS
No difference was found in the release of brain-specific proteins between normothermic and hypothermic CPB, but blood loss was higher after normothermic CPB.
Rasmussen
L S
LS
Department of Anesthesia, Center of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Denmark. lsr@rh.dk
Sztuk
F
F
Christiansen
M
M
Elliott
M J
MJ
D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D008297:Male; D009414:Nerve Growth Factors; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood
D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase