Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass surgery.
OBJECTIVE
Hyperthermia is common in the first 24 hours following coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). An inflammatory response to CPB is often implicated in the pathophysiology of this fever. Unlike CABG with CPB, the temperature pattern after off-pump CABG (OPCAB), where CPB is avoided, has not yet been described. The purpose of this study was to describe the postoperative temperature pattern following OPCAB and to compare it with that following on-pump cardiac surgery.


METHODS
Retrospective, observational study.


METHODS
Tertiary care university hospital.


METHODS
Consenting patients undergoing CABG or OPCAB procedures.


METHODS
Observational.


RESULTS
Of the CABG patients, 89% had temperature elevations above 38 degrees C, versus 44% of the OPCAB patients (P = 0.04). Peak body temperature was higher in the on-pump patients (CABG 38.5 degrees C +/- 0.4 degrees C versus OPCAB 37.9 degrees C +/- 0.5 degrees C; P = 0.002), as was the area under the curve for temperatures greater than 38 degrees C (CABG 1.6 +/- 1.7 degrees C/hr versus OPCAB 0.4 +/- 1.2 degrees C/hr; P = 0.02).


CONCLUSIONS
Off-pump CABG surgery patients experience less hyperthermia compared with on-pump CABG patients. The reasons for a lower incidence and severity of hyperthermia after OPCAB surgery are not known, but may be related to a reduced inflammatory response.
Clark
Jeffrey A
JA
Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710, USA.
Bar-Yosef
Shahar
S
Anderson
Amanda
A
Newman
Mark F
MF
Landolfo
Kevin
K
Grocott
Hilary P
HP
D001831:Body Temperature; D002315:Cardiopulmonary Bypass; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019370:Observation; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors