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Association between postoperative hypothermia and adverse outcome after coronary artery bypass surgery
S R Insler1, M S O'Connor, M J Leventhal
1Department of Cardiothoracic Anesthesia, The Cleveland Clinic Foundation, Ohio 44195, USA. inslers@ccf.org
Insights
Mild hypothermia upon intensive care unit admission is linked to worse outcomes for patients undergoing coronary artery bypass grafting surgery. This includes increased mortality and longer hospital stays, highlighting the importance of maintaining normothermia post-cardiac surgery.
Area of Science:
- Cardiology
- Critical Care Medicine
- Surgical Outcomes
Background:
- Investigating the impact of mild hypothermia (body temperature < 36°C) on patient outcomes immediately following coronary artery bypass grafting (CABG) surgery.
- Focusing on patients admitted to the intensive care unit (ICU) after undergoing CABG with cardiopulmonary bypass (CPB).
Purpose of the Study:
- To determine the association between bladder core temperature (BCT) on ICU admission and patient outcomes after CABG.
- To evaluate the effect of hypothermia versus normothermia on mortality, resource utilization, and morbidity.
Main Methods:
- Retrospective analysis of 5,701 isolated CABG patients who required CPB between January 1995 and June 1997.
- Patients categorized into hypothermic (< 36°C) or normothermic (≥ 36°C) groups based on ICU admission BCT.
- Outcome assessment included mortality, mechanical ventilation duration, ICU/hospital length of stay, transfusion requirements, and major morbidities.
Main Results:
- Patients admitted to the ICU with BCT < 36°C experienced significantly higher mortality rates (p=0.02).
- Hypothermic patients required significantly longer mechanical ventilation (p=0.007) and received more packed red blood cell transfusions (p=0.001).
- A significantly longer ICU (p=0.01) and hospital length of stay (p=0.005) was observed in the hypothermic group.
Conclusions:
- Mild hypothermia (BCT < 36°C) upon ICU admission is significantly associated with adverse outcomes in CABG patients.
- Maintaining normothermia post-cardiac surgery is crucial for improving patient recovery and reducing complications.
- These findings underscore the importance of temperature monitoring and management in the immediate postoperative period for CABG patients.
Background:
We examined the effect on outcome of mild hypothermia (< 36 degrees C) upon intensive care unit (ICU) admission on patient outcome after coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB).
Methods:
We performed a retrospective database analysis of 5,701 isolated CABG patients requiring CPB, operated upon from January 1995 to June 1997. Patients were classified as either hypo- (< 36 degrees C) or normothermic (> or = 36 degrees C) upon ICU admission. ICU admission bladder core temperature (BCT) versus outcome was evaluated. Outcome measures included mortality, resource utilization (mechanical ventilation time, ICU and hospital length of stay, and postoperative packed red blood cell transfusion), and major morbidity (cardiac, renal, neurologic, or major infection).
Results:
Overall, patients admitted to the ICU with BCT < 36 degrees C had a significantly greater mortality (p = 0.02), prolonged mechanical ventilation (p = 0.007), packed red blood cell transfusion (p = 0.001), ICU (p = 0.01), and hospital (p = 0.005) length of stay.
Conclusions:
BCT of less than 36 degrees C, upon ICU admission, has a significant association with adverse outcome after CABG with CPB. M An __ Tl QA_7_t-0