Related Experiment Videos
[Effect of tepid cardiopulmonary bypass in coronary artery bypass operation]
T Yasuda1, M Kawasuji, N Sakakibara
1Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Insights
Maintaining a warmer systemic temperature (32°C) during cardiopulmonary bypass (CPB) surgery significantly shortens procedure time. This tepid perfusion approach did not increase risks like myocardial infarction, stroke, or 30-day mortality compared to colder temperatures.
Area of Science:
- Cardiovascular Surgery
- Cardiopulmonary Bypass
- Myocardial Protection
Background:
- Systemic temperature management during cardiopulmonary bypass (CPB) is critical for patient outcomes.
- Previous research has explored various temperature strategies, but optimal levels remain debated.
Purpose of the Study:
- To evaluate the impact of different systemic temperatures during CPB on surgical outcomes.
- To compare the efficacy and safety of tepid (32°C) versus cold (28°C, 30°C) perfusion during CPB.
Main Methods:
- A prospective study involving 100 patients undergoing CPB surgery.
- Patients were divided into three groups: 28°C, 30°C, and 32°C (tepid) systemic temperature.
- Standardized myocardial protection, pump flow, and perfusion pressure management were employed.
Main Results:
- The 32°C group demonstrated significantly shorter CPB and weaning times compared to 28°C and 30°C groups.
- Medication requirements (methoxamine hydrochloride, phenothiazine) varied significantly between temperature groups.
- No significant differences were observed in postoperative myocardial infarction, stroke, or 30-day mortality rates across groups.
Conclusions:
- Tepid systemic perfusion (32°C) during CPB effectively shortens procedure duration.
- This warmer temperature strategy is comparable to colder perfusion in terms of major postoperative morbidity and mortality.
Abstract:
The effect of systemic temperature during cardiopulmonary bypass (CPB) surgery was evaluated in 100 patients. The patients were divided into three groups, based on systemic temperature during CPB; 28 degrees C, 30 degrees C, or 32 degrees C (tepid). Multidose cold crystalloid cardioplegia was administered for myocardial protection. Pump flow was maintained at 75 ml/kg/min. Methoxamine hydrochloride and phenothiazine were used to maintain systemic perfusion pressures between 60 and 80 mmHg. Preoperatively, there were no differences between groups in left ventricular ejection fraction or extent of coronary artery disease. The time required for CPB and weaning from CPB were significantly shorter in the 32 degrees C group than in either the 28 degrees C or the 30 degrees C group. There were significant differences in the doses of methoxamine hydrochloride and phenothiazine required in each group. Postoperatively, there were no significant differences in the incidence of myocardial infarction, stroke, or 30-day mortality between groups. In conclusion, tepid systemic perfusion shortens the length of CPB and does not differ significantly from cold perfusion with respect to mortality and morbidity.