Continuous jugular venous versus nasopharyngeal temperature monitoring during hypothermic cardiopulmonary bypass for cardiac surgery

Study Objective: To compare jugular venous to nasopharyngeal temperature during hypothermic cardiopulmonary bypass (CPB). Design: Prospective observational study. Setting: Tertiary care teaching hospital. Patients: 5 ASA physical status IV patients (40 to 65 years of age) having cardiac surgery with hypothermic CPB. Interventions, Measurements and Main Results: Jugular venous and nasopharyngeal temperatures were recorded throughout the procedure with comparisons made during four time periods: pre-CPB, during CPB, during rewarming, and lost-CPB. The patients underwent 85.8 +/- 45.8 minutes (mean +/- SD) of hypothermic CPB, cooling to 26.3 +/- 7.6 degrees C (nasopharyngeal) followed by rewarming at 0.35 +/- 0.1 degrees C (nasopharyngeal)/min. There was a high degree of precision between the two temperature sites, but marked differences in bias. In particular, temperature bins was more pronounced during rewarming from CPB compared With other time periods (p < 0.05) where jugular venous temperature was greater than nasopharyngeal temperature by 3.4 degrees C. Conclusion: Nasopharyngeal temperature underestimates jugular venous temperature during rewarming from hypothermic CPB. As a result, the brain may be exposed to periods of hyperthermia, possibly increasing the risk of neurologic injury associated with CPB. (C) 1997 by Elsevier Science Inc.