WARM HEART-SURGERY - A PROSPECTIVE COMPARISON BETWEEN NORMOTHERMIC AND TEPID TEMPERATURE

被引：12

作者：

AROM, KV

EMERY, RW

NORTHRUP, WF

机构：

[1] Minneapolis Heart Institute, Minneapolis, Minnesota

来源：

JOURNAL OF CARDIAC SURGERY | 1995年 / 10卷 / 03期

关键词：

D O I：

10.1111/j.1540-8191.1995.tb00602.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Due to concerns about complications from normothermic core temperature during cardiopulmonary bypass, we initiated a prospective randomized study of 200 consecutive patients. In one group (group A), both the heart and the body temperature were kept at 37 degrees C. In the second group (group B), both the body and myocardial temperature were allowed to drift down to 34 degrees C. There were no differences between these two groups in age, sex, preoperative numbers of elective, urgent, emergent, redo patients, or coronary artery bypass (CAB), valve, CAB/valve procedures. Their preoperative neurological, pulmonary, renal, and vascular disease status were similar. Preoperative EF was 53% in group A (100 patients) and 52.5% in group B (100 patients). Group A required more volume (p = 0.001) and had less urine output (p = 0.03) during and post bypass. Group A required more phenylephrine hydrochloride (p = 0.05) and had more difficulty managing blood pressure. Strokes and renal failure necessitating dialysis occurred more often in group A but without statistical significance. More difficulties occurred in the normothermic (37 degrees C) group and cardioprotective effects of warm heart surgery may remain intact at 34 degrees C. Mild ''drifted/tepid'' hypothermic heart surgery could be a better and safer procedure.

引用

页码：221 / 226

页数：6

共 18 条

[1] Naylor DC, Lichtenstein SV, Fremes SE, Et al., Randomized trial of normothermic versus hypothermic coronary bypass surgery, Lancet, 343, pp. 559-563, (1994)
[2] Menasche P, Peynet J, Touchot B, Et al., Normothermic cardioplegia: Is aortic cross‐clamping still synonymous with myocardial ischemia?, Ann Thorac Surg, 54, pp. 472-478, (1992)
[3] Vaughn CC, Opie JC, Florendo FT, Et al., Warm blood cardioplegia, Ann Thorac Surg, 55, pp. 1227-1232, (1993)
[4] Lichtenstein SV, Ashe KA, Dalati HE, Et al., Warm heart surgery, J Thorac Cardiovasc Surg, 101, pp. 269-274, (1993)
[5] Gundry SR, Wang N, Bannon D, Et al., Retrograde continuous warm blood cardioplegia: Maintenance of myocardial homeostasis in humans, Ann Thorac Surg, 55, pp. 358-363, (1993)
[6] Nobuhiko H, Ikonomidis JS, Weisel RD, The optimal cardioplegic temperature, Ann Thorac Surg, 58, pp. 961-971, (1994)
[7] Martin TD, Carver JM, Gott JP, Et al., Prospective, randomized trial of retrograde warm blood cardioplegia: Myocardial benefit and neurologic threat, Ann Thorac Surg, 57, pp. 298-304, (1994)
[8] Emery RW, Arom KV, Results with retrograde delivery of cardioplegia for myocardial protection during cardiac surgery, J Cardiovasc Surg, 34, pp. 123-128, (1993)
[9] Arom KV, Emery RW, Coronary sinus cardioplegia: Clinical trial without antegrade‐retrograde approach, Ann Thorac Surg, 53, pp. 714-715, (1992)
[10] Arom KV, Cohen DE, Strobl FT, Effect of intraoperative intervention on neurological outcome based on electroencephalographic monitoring during cardiopulmonary bypass, Ann Thorac Surg, 48, pp. 476-483, (1989)

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