Changes in body temperature during profound hypothermic cardiopulmonary bypass in adult patients undergoing aortic arch reconstruction

被引：13

作者：

Akata T. ^{[1
]}

Yamaura K. ^{[1
]}

Kandabashi T. ^{[1
]}

Sadamatsu S. ^{[1
]}

Takahashi S. ^{[1
]}

机构：

[1] Dept. Anesthesiol./Crit. Care Med., Faculty of Medicine, Kyushu University, Higashi-ku, Fukuoka 812-8582

来源：

Journal of Anesthesia | 2004年 / 18卷 / 2期

关键词：

Cardiopulmonary bypass; Core temperature; Deep hypothermia; Induced hypothermia; Thoracic aortic aneurysm;

D O I：

10.1007/s00540-003-0225-1

中图分类号：

学科分类号：

摘要：

Purpose. Our aim was to characterize changes in body temperatures during profound hypothermic cardiopulmonary bypass (CPB) conducted with the sternum opened. Methods. In ten adult patients who underwent profound hypothermic (<20°C) CPB for aortic arch reconstruction, pulmonary arterial temperature (PAT), nasopharyngeal temperature (NPT), forehead deep-tissue temperature (FHT), and urinary bladder temperature (UBT) were recorded every 1 min throughout the surgery. In addition, the CPB venous line temperature (CPBT), a reasonable indicator of mixed venous blood temperature during CPB and believed to best reflect core temperature during stabilized hypothermia on CPB, was recorded during the period of total CPB. Results. PAT began to change immediately after the start of cooling or rewarming, closely matching the CPBT (r = 0.98). During either situation, the other four temperatures lagged behind PAT (P < 0.05); however, NPT followed PAT more closely than the other three temperatures (P < 0.05). During stabilized hypothermia, PAT, NPT, and FHT, but not UBT, closely matched the CPBT, with gradients of less than 0.5°C. Conclusion. During induction of profound hypothermia and its reversal on total CPB with the heart in situ, a PA catheter thermistor, presumably because of its placement immediately behind the superior vena cava, would provide a reliable measure of the mixed venous blood temperature. During stabilized profound hypothermia, PAT, NPT, and FHT, but not UBT, serve as a reliable index of core temperature. © JSA 2004.

引用

页码：73 / 81

页数：8

共 34 条

[1]

Kurusz M., Davis R.F., Conti V.R., Conduct of cardiopulmonary bypass, Cardiopulmonary Bypass, pp. 549-577, (2000)

[2]

Skeehan T.M., Jopling M., Monitoring the cardiac surgical patient, A Practical Approach to Cardiac Anesthesia, pp. 98-140, (2003)

[3]

Davis R.B., Kauffman J.N., Cobbs T.L., Mick S.L., Assembling and monitoring the extracorporeal circuit, Cardiopulmonary Bypass, pp. 238-246, (1995)

[4]

Stone J.G., Young W.L., Smith C.R., Solomon R.A., Wald A., Ostapkovich N., Shrebnick D.B., Do standard monitoring sites reflect true brain temperature when profound hypothermia is rapidly induced and reversed?, Anesthesiology, 82, pp. 344-351, (1995)

[5]

Muravchick S., Conrad D.P., Vargas A., Peripheral temperature monitoring during cardiopulmonary bypass operation, Ann. Thorac. Surg., 29, pp. 36-41, (1980)

[6]

Azar I., Rectal temperature is best indicator of adequate rewarming during cardiopulmonary bypass, Anesthesiology, 55, pp. 189-190, (1981)

[7]

Ramsay J.G., Ralley F.E., Whalley D.G., DelliColli P., Wynands J.E., Site of temperature monitoring and prediction of afterdrop after open heart surgery, Can. J. Anaesth., 32, pp. 607-612, (1985)

[8]

Rudy Jr. L.W., Heymann M.A., Edmunds Jr. L.H., Distribution of systemic blood flow during cardiopulmonary bypass, J. Appl. Physiol., 34, pp. 194-200, (1973)

[9]

Werner J., Buse M., Temperature profiles with respect to inhomogeneity and geometry of the human body, J. Appl. Physiol., 65, pp. 1110-1118, (1988)

[10]

Hercus V., Cohen D., Bowring A.C., Temperature gradients during hypothermia, BMJ, 1, pp. 1439-1441, (1959)

← 1 2 3 4 →