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Cerebral hyperthermia in children after cardiopulmonary bypass

B Bissonnette1, H M Holtby, A J Davis

  • 1Departments of Anesthesia and Surgery, Division of Cardiovascular Surgery, the Hospital for Sick Children, and the University of Toronto, Toronto, Ontario, Canada. bruno@anaes.sickkids.on.ca

Anesthesiology
|September 2, 2000
PubMed

Insights

Cerebral hyperthermia in children post-cardiopulmonary bypass is significant. Jugular venous bulb temperature (JVBT) rises substantially and doesn't correlate with other core temperatures during recovery.

Area of Science:

  • Pediatric Cardiology
  • Neuroscience
  • Critical Care Medicine

Background:

  • Cerebral hyperthermia following hypothermic cardiopulmonary bypass is under-documented in adults and unstudied in children.
  • This study aimed to monitor brain temperature in pediatric patients during and after cardiopulmonary bypass.

Purpose of the Study:

  • To investigate the incidence and patterns of cerebral hyperthermia in infants and children after cardiopulmonary bypass.
  • To compare jugular venous bulb temperature (JVBT) with other core temperature measurements during the recovery period.

Main Methods:

  • Fifteen pediatric patients (3 months–6 years) undergoing cardiopulmonary bypass were studied.
  • Jugular venous bulb temperature (JVBT) was measured using a retrograde jugular bulb catheter.
  • Core blood temperature and other sites (tympanic, esophageal, rectal) were monitored for 6 hours post-bypass.

Main Results:

  • Mean JVBT significantly increased post-bypass, reaching 39.6°C after 6 hours.
  • JVBT showed a distinct rewarming pattern (y = 0.006x + 37.21, r² = 0.97).
  • While tympanic, esophageal, and rectal temperatures correlated with JVBT, they failed to accurately reflect JVBT during recovery.

Conclusions:

  • Pediatric patients experience significant cerebral hyperthermia after cardiopulmonary bypass.
  • Standard core temperature monitoring methods are insufficient to track brain temperature changes during recovery in this population.
  • Understanding these temperature discrepancies is crucial for elucidating factors contributing to neurological injury in pediatric patients.
Abstract

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