Naslov
Temperature Management for Valvular Surgery Patients.

Autori
Mrkonjić, Ružica ; Marušić, Natalija ; Solarić, Mladen ; Lukačević, Nenad ; Sentić, Marko ; Barić, Davor

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Developments in Perfusion / Hamilton, Carole - Lisabon, 2011, 13-14

Skup
11th European Conference on Perfusion Education and Training

Mjesto i datum
Lisabon, Portugal, 01.10.2011

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Recenziran

Ključne riječi
temperature management, valvular surgery

Sažetak
Introduction: There have been a variety of changes in temperature management trends in cardiac surgery. In the early days of Cardiopulmonary Bypass (CPB) the practice was conducted at normothermia. The addition of hypothermia to CPB has been standard practice since Bigelow, in 1950 demonstrated improved tolerance of the entire organism to ischemia accompanied by hypothermia. Hypothermia served as a means of reducing tissue metabolism hence decreasing tissue oxygen consumption which protects the organs against hypoperfusion and hypoxia. Many cardiac centers today use moderate hypothermia and normothermia in adult surgery. The aim of this study is to evaluate the efficiency and safety of normothermic versus moderate hypothermic CPB in valvular surgery patients. Methods: We retrospectively reviewed the records of 50 consecutive patients undergoing valvular surgery from May 2010-May 2011. Normothermic CPB (36°–37°C) n=23 and hypothermic CPB (29°–31°C) n=27. Outcome measures included mortality, major morbidity (cardiac, renal, neurologic, or major infection), need for perioperative inotropic support, extra volume on CPB, total units of red cell transfused and post-operative chest tube bleeding. Results: There were no significant demographic and surgical characteristic differences between the group of patients. There was no perioperative mortality. No patients required dialysis in the early postoperative period. Normothermic group: CPB vasopressor requirement (MAP > 60 mmHg): 82% Early postoperative period, systemic vascular resistance 1162 ± 302 24 hour post-op blood loss 599±309 ml Administration of extra volume during CPB: 666±494ml of infusions p=0, 484 Transfusion requirement (keep HCT > 20%): n=7 (30.4%) Mean total RBC transfusion during perioperative period: 1030±417ml Delirium: n=1 14 Hypothermic group: 30 day mortality n=2 (sepsis) CPB vasopressor requirement (MAP > 60 mmHg): 66% Early postoperative period, systemic vascular resistance 1249 ± 402 dyne·s· cm−5, p=0.461 24 hour post-op blood loss 642±329 ml p= 0.653 Administration of extra volume during CPB: 796±653 ml of infusions Transfusion requirement (keep HCT > 20%): n=8 (29.6%) Mean total RBC transfusion during perioperative period: 1036±524ml Delirium: n=1 Moderate increase in serum creatinine level (30-50%) n=2. Prolonged ventilation ( ≥ 24h): n=1 Perioperative myocardial infarction: n=1 Superficial surgical site infections: n=3 (13%) Conclusion: Current evidence does not support one temperature management strategy for all patients. These data suggest that normothermic systemic perfusion during CPB in valvular surgery patients is as safe as moderate hypothermic CPB.

Izvorni jezik
Engleski

Znanstvena područja
Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

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