Regional oxygenation and systemic inflammatory response during cardiopulmonary bypass: influence of temperature and blood flow variations.

To evaluate the role of target temperature (28 degrees or 34 degrees C) in cardiac surgery on regional oxygenation during hypothermia and rewarming and systemic inflammatory response. Prospective, controlled, and randomized clinical study. University hospital. Elderly patients (mean age 70 +/- 2 years) with acquired heart disease with an anticipated bypass time exceeding 120 minutes (n = 30). The patients were cooled to either 28 degrees C (n = 15) or 34 degrees C (n = 15). At hypothermia, bypass blood flow was reduced twice from full flow (2.4 L/min/m(2) body surface area [BSA]) to 2.0 L/min/m(2). Hepatic and jugular venous oxygen tension and saturation were higher at 28 degrees C than at 34 degrees C. In comparison with the preoperative values, at 28 degrees C hepatic venous values were higher; whereas at 34 degrees C, they were lower. The reduction of pump blood flow during hypothermia, from 2.4 to 2.0 L/min/m(2)was accompanied by reductions of central, jugular, and hepatic oxygenation at both target temperatures. During rewarming, central and regional venous oxygenation decreased irrespective of the preceding temperature. The decrease was most pronounced in hepatic venous blood, with the lowest individual values <10%. Serum concentrations of C3a and IL-6 increased during hypothermia and increased further during rewarming irrespective of the preceding temperature. During cardiopulmonary bypass, hypothermia at 28 degrees C increases regional and central venous oxygenation better than at 34 degrees C. In contrast, venous oxygenation decreases during rewarming irrespective of the preceding temperature. No significant difference in the systemic inflammatory response associated with target temperature was detected.

Lindholm L ，Bengtsson A ，Hansdottir V ，Lundqvist M ，Rosengren L ，Jeppsson A ... -  《JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA》

Adequacy of perfusion during hypothermia: regional distribution of cardiopulmonary bypass flow, mixed venous and regional venous oxygen saturation - hypothermia and distribution of flow and oxygen.

Schmid FX ，Philipp A ，Foltan M ，Jueckstock H ，Wiesenack C ，Birnbaum D ... -  《THORACIC AND CARDIOVASCULAR SURGEON》

Correlation between cerebral and mixed venous oxygen saturation during moderate versus tepid hypothermic hemodiluted cardiopulmonary bypass.

Baraka A ，Naufal M ，El-Khatib M 《JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA》

Neurocognitive function in patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass: the effect of two different rewarming strategies.

Sahu B ，Chauhan S ，Kiran U ，Bisoi A ，Lakshmy R ，Selvaraj T ，Nehra A ... -  《-》

Neuropsychological function in children with cyanotic heart disease undergoing corrective cardiac surgery: effect of two different rewarming strategies.

Sahu B ，Chauhan S ，Kiran U ，Bisoi A ，Ramakrishnan L ，Nehra A ... -  《-》