A core review of temperature regimens and neuroprotection during cardiopulmonary bypass: does rewarming rate matter?
Despite a half century of research and the implementation of various risk-reduction strategies among clinicians and basic scientists, patients continue to experience strokes and cognitive dysfunction related to the use of cardiopulmonary bypass (CPB) for cardiac surgery. One strategy to reduce these detrimental effects has been the use of hypothermia. Although numerous studies have addressed the issue, the question of whether the use of hypothermia during CPB attenuates the impact of central nervous system consequences remains unresolved. However, data clearly demonstrate that hyperthermia is to be avoided in the perioperative period, necessitating careful rewarming strategies if hypothermia is used during CPB. Selecting and understanding the impact of the temperature-monitoring site is important to accurately estimate cerebral temperature and to avoid inadvertent surges in brain temperature. In this article, we review the literature regarding the impact of hypothermia and rewarming rates during cardiac surgery.
Grigore
Alina M
AM
Department of Anesthesiology, Mayo Hospital, 5777 East Mayo Blvd., Phoenix, AZ 85054, USA. grigore.alina@mayo.edu
Murray
Catherine Friederich
CF
Ramakrishna
Harish
H
Djaiani
George
G
D001833:Body Temperature Regulation; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002493:Central Nervous System Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D007036:Hypothermia, Induced; D016343:Monitoring, Intraoperative; D017410:Practice Guidelines as Topic; D017694:Rewarming / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors