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Cardiopulmonary bypass, rewarming, and central nervous system dysfunction

M I Buss1, R F McLean, B I Wong

  • 1Department of Anaesthesia, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.

The Annals of Thoracic Surgery
|May 1, 1996
PubMed
Summary

Elevated rewarming temperatures above 38°C during cardiopulmonary bypass did not show significant early cognitive decline. A potential later decline in visual memory warrants further investigation into cerebral hyperthermia risks.

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Area of Science:

  • Cardiovascular Surgery
  • Neuroscience
  • Temperature Regulation

Background:

  • Cerebral hyperthermia (nasopharyngeal temperature >38°C) post-cardiopulmonary bypass may worsen ischemic brain injury.
  • Understanding the impact of rewarming temperature on neurological outcomes is critical.

Purpose of the Study:

  • To investigate the association between elevated rewarming temperatures and neuropsychological outcomes after aortocoronary bypass surgery.
  • To determine if hyperthermia during rewarming impacts cognitive function.

Main Methods:

  • Compared neuropsychological test scores in 150 aortocoronary bypass patients.
  • 66 patients with rewarming temperatures >38°C were compared to a control group.
  • Demographic and intraoperative variables were controlled for.

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Main Results:

  • A trend suggested poorer early postoperative neuropsychological test performance in hyperthermic patients.
  • No significant differences were observed in the early postoperative period.
  • Hyperthermic patients showed worse visual reproduction scores at 3 months (p=0.02) via ANCOVA, but not linear regression (p=0.10).

Conclusions:

  • No significant cognitive deterioration was demonstrated in the early postoperative period for patients rewarmed to >38°C.
  • The observed 3-month difference in visual reproduction warrants further study but is not conclusive.
  • Caution regarding rewarming temperatures is advised pending more research.