Temperature management and monitoring practices during adult cardiac surgery under cardiopulmonary bypass: results of a Canadian national survey.

https://arctichealth.org/en/permalink/ahliterature134381
Source
Perfusion. 2011 Sep;26(5):395-400
Publication Type
Article
Date
Sep-2011
Author
D. Belway
R. Tee
H J Nathan
F D Rubens
M. Boodhwani
Author Affiliation
Department of Perfusion Services, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Source
Perfusion. 2011 Sep;26(5):395-400
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Body temperature
Canada
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Data Collection
Female
Humans
Hypothermia - etiology - physiopathology
Male
Monitoring, Intraoperative - methods
Abstract
Mild to moderate systemic hypothermia is commonly used as a cerebral protective strategy during adult cardiac surgery. The benefits of this strategy for routine cardiac surgery have been questioned and the adverse effects of hyperthermia demonstrated. The purpose of the present study was to examine current temperature management and monitoring practices during adult cardiac surgery using CPB in Canada.
Web-based survey referring to adult cases undergoing cardiac surgery using CPB without the use of deep hypothermic circulatory arrest. Thirty-two questionnaires were completed, representing a 100% response rate.
The usual management is to cool patients during CPB at 30 (94%) centers for low-risk (isolated primary CABG) cases and at 31 (97%) centers for high-risk (all other) cases. The average nadir temperature at the target site achieved on CPB is 34°C (range 28°C - 36°C). At 26 (81%) centers, patients are typically rewarmed to a target temperature between 36°C and 37°C before separation from CPB. Only 6 (19%) centers reported that thermistors and coupled devices used to monitor blood temperature are checked for accuracy or calibrated according to the product operating directive's schedule or more often.
Contemporary management of adult cardiac surgery under CPB still involves induction of mild to moderate systemic hypothermia. Significant practice variation exists across the country with respect to target temperatures for cooling and rewarming, as well as the site for temperature monitoring. This probably reflects the lack of definitive evidence. There is a need for well-conducted clinical trials to provide more robust evidence regarding temperature management.
PubMed ID
21593083 View in PubMed
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