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

Takashi Akata, Ken Yamaura, Tadashi Kandabashi, Shinya Sadamatsu, Shosuke Takahashi

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)73-81
Number of pages9
JournalJournal of Anesthesia
Volume18
Issue number2
DOIs
Publication statusPublished - Aug 11 2004

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Body Temperature Changes
Cardiopulmonary Bypass
Thoracic Aorta
Temperature
Hypothermia
Lung
Urinary Bladder

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Changes in body temperature during profound hypothermic cardiopulmonary bypass in adult patients undergoing aortic arch reconstruction. / Akata, Takashi; Yamaura, Ken; Kandabashi, Tadashi; Sadamatsu, Shinya; Takahashi, Shosuke.

In: Journal of Anesthesia, Vol. 18, No. 2, 11.08.2004, p. 73-81.

Research output: Contribution to journalArticle

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AU - Takahashi, Shosuke

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N2 - 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.

AB - 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.

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