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Fingertip temperature during cardiopulmonary bypass
J Johnson1, J B Desai, J Ponte
1Department of Cardiothoracic Surgery, King's College Hospital, Denmark Hill, London.
Perfusion
|March 1, 1997
Summary
During cardiopulmonary bypass rewarming, fingertip temperature, not nasopharyngeal temperature, may indicate when brain temperature reaches normothermia. Avoid excessive warming to prevent brain hyperthermia.
Area of Science:
- Cardiovascular Surgery
- Physiology
- Medical Monitoring
Background:
- Hypothermic cardiopulmonary bypass (CPB) is used during cardiac surgery to reduce metabolic demand.
- Effective rewarming is crucial to prevent complications associated with hypothermia.
- Accurate monitoring of core body temperature, particularly brain temperature, is essential during rewarming.
Purpose of the Study:
- To evaluate the reliability of nasopharyngeal and fingertip temperatures as indicators of brain rewarming during CPB.
- To determine optimal rewarming strategies to avoid brain hyperthermia.
Main Methods:
- Continuous temperature monitoring in nasopharynx, fingertip, forearm, and extracorporeal circuit.
- Data collected during the rewarming phase of hypothermic (32°C) CPB in 14 coronary artery revascularization patients.
- Analysis of temperature changes in relation to arterial blood temperature and rewarming time.
Main Results:
- Arterial blood temperature increased first, followed by nasopharyngeal and fingertip temperatures.
- Fingertip temperature showed an abrupt increase approximately 6.2 minutes after rewarming began.
- At the fingertip temperature increase, nasopharyngeal temperature was 34.2°C and took an additional 8.3 minutes to reach 37°C.
Conclusions:
- Nasopharyngeal temperature is an unreliable indicator of brain temperature during CPB rewarming.
- Fingertip temperature may serve as a useful monitor for achieving cerebral normothermia.
- Arterial temperatures ≥39°C during rewarming should be avoided to prevent the risk of brain hyperthermia.