Canadian Journal of Anaesthesia

, Volume 42, Issue 8, pp 663–668 | Cite as

Hypothermic cardiopulmonary bypass — time for a more temperate approach?

  • John M. Murkin

Réflexions sur la circulation extracorporelle hypothermique


  1. 1.
    Jones EL, Weintraub WS, Craver JM, Guyton RA, Cohen CL. Coronary bypass surgery: is the operation different today? J Thorac Cardiovasc Surg 1991; 101: 108–15.PubMedGoogle Scholar
  2. 2.
    Cosgrove DM, Loop FD, Lyttle BW, et al. Primary myocardial revascularization: trends in surgical mortality. J Thorac Cardiovasc Surg 1984; 88: 673–84.PubMedGoogle Scholar
  3. 3.
    Turnan KJ, McCarthy RJ, Najafi H, Ivankovich AD. Differential effects of advanced age on neurologic and cardiac risks of coronary artery operations. J Thorac Cardiovasc Surg 1992; 104: 1510–7.Google Scholar
  4. 4.
    Padayachee TS, Parsons S, Theobold R, Linley J, Gosling RG, Deverell PB. The detection of microemboli in the middle cerebral artery during cardiopulmonary bypass: a transcranial Doppler ultrasound investigation using membrane and bubble oxygenators. Ann Thorac Surg 1987; 44: 298–302.PubMedGoogle Scholar
  5. 5.
    Blauth CI, Smith PL, Arnold JV, Jagoe RJ, Wooton R, Taylor KM. Influence of oxygenator type on the prevalence and extent of microembolic retinal ischemia during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1990; 99: 61–9.PubMedGoogle Scholar
  6. 6.
    Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S. The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 1994; 25: 1393–9.PubMedGoogle Scholar
  7. 7.
    Murkin JM, Martzke JS, Buchan AM, Bentley C, Wong CJ. A randomized study of the influence of perfusion technique and pH management strategy in 316 patients undergoing coronary artery bypass surgery: II. Neurologic and cognitive outcomes. J Thorac Cardiovasc Surg 1995 (in press).Google Scholar
  8. 8.
    Stephan H, Weyland A, Kazmaier S, Henze T, Menck S, Sonntag H. Acid-base management during hypothermic cardiopulmonary bypass does not affect cerebral metabolism but does affect blood flow and neurological outcome. Br J Anaesth 1992; 69: 51–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Padayachee TS, Parsons S, Theobold R, Gosling RG, Deveral PB. The effect of arterial filtration on reduction of gaseous microemboli in the middle cerebral artery during cardiopulmonary bypass. Ann Thorac Surg 1988; 45: 647–9.PubMedGoogle Scholar
  10. 10.
    Marschall K, Kanchuger M, Kessler K, et al. Superiority of transesophageal echocardiography in detecting aortic arch disease: identification of patients at increased risk of stroke during cardiac surgery. J Cardiothorac Vasc Surg 1994; 8: 5–13.CrossRefGoogle Scholar
  11. 11.
    Nathan HJ, Lavallee G. The management of temperature during hypothermie cardiopulmonary bypass: I — Canadian survey. Can J Anaesth 1995; 42: 669–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Nathan HJ, Polis T. The management of temperature during hypothermie cardiopulmonary bypass: II — Effect of prolonged hypothermia. Can J Anaesth 1995; 42: 672–6.PubMedGoogle Scholar
  13. 13.
    Drummond JC. Brain protection during anaesthesia: a reader’s guide. Anesthesiology 1993; 79: 877–80.PubMedCrossRefGoogle Scholar
  14. 14.
    Muravchick S. Deep body thermometry during general anesthesia. Anesthesiology 58; 271–5, 1983.PubMedCrossRefGoogle Scholar
  15. 15.
    Shaw PJ, Bates D, Cantlidge EF, et al. Early intellectual dysfunction following coronary bypass surgery. Q J Med 1986; 58: 59–68.PubMedGoogle Scholar
  16. 16.
    Smith PLC, Newman SP, Ell PJ, Harrison MJG, Treasure T, Joseph P. Cerebral consequences of cardiopulmonary bypass. Lancet 1986; 1: 823–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Venn G, Klinger L, Smith P, Harrison M, Newman SP, Treasure T. Neuropsychological sequelae of bypass twelve months after coronary artery surgery. Br Heart J 1987; 57: 565.Google Scholar
  18. 18.
    Brown WR, Moody DM, Stump DA, Deal DD, Anderson RL. Dog model for cerebrovascular studies of the proximal-to-distal distribution of sequentially injected emboli. Microvasc Res 1995 (in press).Google Scholar
  19. 19.
    Busto R, Dietrich WD, Globus MY-T, Ginsberg MD. The importance of brain temperature in cerebral injury. Stroke 1989; 20: 1113–4.PubMedGoogle Scholar
  20. 20.
    Buchan A, Pulsinelli WA. Hypothermia but not the Nmethyl-D-aspartate antagonist, MK-801, attenuates neuronal damage in gerbils subjected to transient global ischemia. J Neurosci 1990; 10: 311–6.PubMedGoogle Scholar
  21. 21.
    Chopp M, Knight R, Tidwell CD, Helpern JA, Brown E, Welch KMA. The metabolic effects of mild hypothermia on global cerebral ischemia and recirculation in the cat: comparison of normothermia to hyperthermia. J Cereb Blood Flow Metab 1989; 9: 141–8.PubMedGoogle Scholar
  22. 22.
    McLean RF, Wong BI, Naylor D, et al. Cardiopulmonary bypass, temperature, and central nervous system dysfunction. Circulation 1994; 90 (part 2): II-250–5.Google Scholar
  23. 23.
    The Warm Heart Investigators. Randomized trial of normothermic versus hypothermic coronary bypass surgery. Lancet 1994; 343: 559–63.CrossRefGoogle Scholar
  24. 24.
    Martin TD, Craver JM, Gott JP, Weintraub WS, Ramsay J, Mora CT, Guyton RA. Prospective, randomized trial of retrograde warm blood cardioplegia: myocardial benefit and neurologic threat. Ann Thorac Surg 1994; 57: 298–304.PubMedCrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists 1995

Authors and Affiliations

  • John M. Murkin

There are no affiliations available

Personalised recommendations