title: Highest core temperature during cardiopulmonary bypass and rate of mediastinitis.
abstract: Temperature control during cardiopulmonary bypass (CPB) may be related to rates of bacterial infection. We assessed the relationship between highest core temperature during CPB and rates of mediastinitis in 6955 consecutive isolated coronary artery bypass graft (CABG) procedures in northern New England. The overall rate of mediastinitis was 1.1%. The association between highest core temperature and mediastinitis was different for diabetics than for nondiabetics. A multivariate model showed that there was a significant interaction between diabetes and temperature in their association with mediastinitis (p=0.015). Diabetic patients showed higher rates of mediastinitis as highest core temperature increased, from 0.7% in the < or = 37 degrees C group to 3.3% in the > or = 38 degrees C group (p(trend) = 0.002). Adjusted rates were similar. Nondiabetic patients did not show this trend (p(trend) = 0.998). Among diabetic patients, a peak core body temperature > 37.9 degrees C during CPB is a significant risk factor for development of mediastinitis. Avoidance of higher temperatures during CPB may lower the risk of mediastinitis for diabetic patients undergoing CABG surgery.
authors.affiliation: Maine Medical Center, Portland, ME 04102, USA. GROOMR@mmc.org
authors.forename: Robert C
authors.initials: RC
authors.lastname: Groom
authors.forename: Athos J
authors.initials: AJ
authors.lastname: Rassias
authors.forename: John E
authors.initials: JE
authors.lastname: Cormack
authors.forename: Gordon R
authors.initials: GR
authors.lastname: DeFoe
authors.forename: Christian
authors.initials: C
authors.lastname: DioDato
authors.forename: Charles K
authors.initials: CK
authors.lastname: Krumholz
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Forest
authors.forename: John W
authors.initials: JW
authors.lastname: Pieroni
authors.forename: Brian
authors.initials: B
authors.lastname: O'Connor
authors.forename: Craig S
authors.initials: CS
authors.lastname: Warren
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Olmstead
authors.forename: Cathy S
authors.initials: CS
authors.lastname: Ross
authors.forename: Gerald T
authors.initials: GT
authors.lastname: O'Connor
mesh_terms: D000368:Aged; D001831:Body Temperature; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D005334:Fever; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology*; D016491:Peripheral Vascular Diseases / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors