Effects of topical hypothermia on postoperative inflammatory markers in patients undergoing coronary artery bypass surgery.
BACKGROUND
We aimed to examine the effects of topical hypothermia on inflammatory markers in patients undergoing coronary artery bypass surgery.


METHODS
Fifty patients undergoing isolated coronary artery bypass surgery were included the study. They were randomised to two groups. Mild hypothermic cardiopulmonary bypass (28-32°C) was performed on both groups using standardised anaesthesiology and surgical techniques. Furthermore, topical cooling with 4°C saline was performed on patients in group I. We recorded peri-operative and intra-operative results of blood samples, pre-operative and postoperative outcomes of electrocardiography and echocardiography, diaphragm levels on X-ray, and the necessity of positive inotropic medication and intra-aortic balloon pump (IABP).


RESULTS
Time-dependent changes in blood samples were compared between the two groups. The changes on complement 3 (C3) and TNF-α levels were more significant in group I than group II (p < 0.05 and p < 0.001, respectively). Spontaneous restoration rate of sinus rhythm was higher in group II than group I (80 vs 32%, p < 0.01). Atrial fibrillation was seen in six patients in group I and one patient in group II (p < 0.05). IABP was performed on four patients (16%) in group I (p < 0.05). Diaphragmatic paralysis was seen in seven patients in group I but not in group II (p < 0.01). Partial pericardiotomy rates were compared within the groups but there was no statistically significant difference (p > 0.05). One patient in group I died on the 18th postoperative day, but operative mortality rate was not statistically significant between the two groups (p > 0.05).


CONCLUSIONS
Topical hypothermia had a negative impact on inflammatory markers and postoperative morbidities.
Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik, Ankara, Turkey. muratkadan@yahoo.com.
Murat
M
Kadan
Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik, Ankara, Turkey.
Gokhan
G
Erol
Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik, Ankara, Turkey.
Bilgehan Savas
BS
Oz
Department of Cardiovascular Surgery, Gulhane Military Academy of Medicine, Etlik, Ankara, Turkey.
Mehmet
M
Arslan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007249:Inflammation / Q000378:metabolism / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*
D015415:Biomarkers