Changes in body temperature during profound hypothermic cardiopulmonary bypass in adult patients undergoing aortic arch reconstruction.
OBJECTIVE
Our aim was to characterize changes in body temperatures during profound hypothermic cardiopulmonary bypass (CPB) conducted with the sternum opened.


METHODS
In ten adult patients who underwent profound hypothermic (< 20 degrees C) CPB for aortic arch reconstruction, pulmonary arterial temperature (PAT), nasopharyngeal temperature (NPT), forehead deep-tissue temperature (FHT), and urinary bladder temperature (UBT) were recorded every 1 min throughout the surgery. In addition, the CPB venous line temperature (CPBT), a reasonable indicator of mixed venous blood temperature during CPB and believed to best reflect core temperature during stabilized hypothermia on CPB, was recorded during the period of total CPB.


RESULTS
PAT began to change immediately after the start of cooling or rewarming, closely matching the CPBT ( r = 0.98). During either situation, the other four temperatures lagged behind PAT ( P < 0.05); however, NPT followed PAT more closely than the other three temperatures ( P < 0.05). During stabilized hypothermia, PAT, NPT, and FHT, but not UBT, closely matched the CPBT, with gradients of less than 0.5 degrees C.


CONCLUSIONS
During induction of profound hypothermia and its reversal on total CPB with the heart in situ, a PA catheter thermistor, presumably because of its placement immediately behind the superior vena cava, would provide a reliable measure of the mixed venous blood temperature. During stabilized profound hypothermia, PAT, NPT, and FHT, but not UBT, serve as a reliable index of core temperature.
Akata
Takashi
T
Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Kyushu University, Higashi-ku, 812-8582, Fukuoka, Japan.
Yamaura
Ken
K
Kandabashi
Tadashi
T
Sadamatsu
Shinya
S
Takahashi
Shosuke
S
D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001769:Blood; D001831:Body Temperature; D002315:Cardiopulmonary Bypass; D005260:Female; D005385:Fingers; D005546:Forehead; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009305:Nasopharynx; D011651:Pulmonary Artery; D017694:Rewarming; D012881:Skin Temperature; D001743:Urinary Bladder; D014556:Urine; D014680:Veins