End-point temperature of rewarming after hypothermic cardiopulmonary bypass in pediatric patients

Area of Science:

• Cardiovascular Surgery
• Pediatric Critical Care
• Thermoregulation

Background:

• Hypothermic cardiopulmonary bypass (CPB) is used in pediatric cardiac surgery.
• Establishing an adequate end-point rewarming temperature is crucial to prevent complications like afterdrop.
• Pediatric patients require specific considerations for rewarming protocols.

Purpose of the Study:

• To determine if a rectal rewarming temperature of 35.5°C is adequate post-hypothermic cardiopulmonary bypass (CPB).
• To investigate the occurrence of temperature afterdrop in pediatric patients following cardiac surgery.
• To compare physiological parameters at different rewarming endpoints.

Main Methods:

• Randomized controlled trial involving 50 pediatric patients undergoing cardiac surgery.
• Patients were assigned to end-point rectal rewarming temperatures of 35.5°C or 37.0°C.
• Rectal temperature, heart rate, and blood pressure were monitored post-intensive care unit arrival.

Main Results:

• No statistically significant difference in rectal temperatures between the 35.5°C and 37.0°C groups.
• No temperature afterdrop was observed in any patient.
• Heart rate and blood pressure showed no significant differences between groups; no shivering occurred.

Conclusions:

• Restoring pediatric patients' rectal temperature to above 35.5°C at the end of CPB appears sufficient.
• A rewarming endpoint of 35.5°C may prevent post-CPB temperature afterdrop in pediatric cardiac surgery.
• This finding supports optimizing rewarming strategies in pediatric cardiac procedures.