Related Experiment Video
Updated: Oct 2, 2026
Large-Animal Model of Donation after Circulatory Death and Normothermic Regional Perfusion for Cardiac Assessment
Published on: May 10, 2022
Clinical evaluation of normothermic cardiopulmonary bypass and cold cardioplegia
1Department of Cardiac Surgery, Second University of Naples Medical School, V. Monaldi Hospital, Naples, Italy. Gianantonio.Nappi@unina2.it
Background:
To evaluate the validity of normothermic cardiopulmonary bypass (CPB) associated with topical hypothermia and cold cardioplegia technique.
Methods:
In a clinical prospective trial, a consecutive series of 100 patients, homogeneous for demographics, clinical and operative data, undergoing coronary artery bypass surgery were randomized for hypothermic CPB (rectal temperature 28-32 degrees C group A, 50 patients) and normothermic CPB (rectal temperature 35-37 degrees C, group B, 50 patients). In both groups of patients cold crystalloid cardioplegic solution and topical hypothermia was used.
Results:
During CPB group B patients had lower systemic vascular resistance (p=0.0001); they needed a significant (p=0.0001) increase in vasocostrictive. At the removal of aortic cross-clamp, a spontaneous sinus rhythm resumed in 48% of patients in group A and in 95% of group B patients (p=0.001). To disconnect CPB, vasoconstrictive drugs were used in 10% of patients in group B and in none of patients in group A (p=0.0001); vasodilating drugs were infused in 96% of patients in group A and in 40% of patients in group B (p=0.0001). In the immediate postoperative period, positive inotropic agents were used in 67% of patients in group A and in 22% of patients in group B (p= 0.0003); group B patients showed a more physiological rewarming, reduced periods of mechanical ventilation and an easier regulation of the volemia.
Conclusions:
In our clinical experience the technique of cold heart and warm body proved to be safe and effective in simplifying surgical procedures and facilitating postoperative management.
