Abstract
We studied the clinical advantages and myocardial protection of normothermal CPB with comparing to hypothermal CPB. 22-cases of adult CABG were classified under two groups, according to the temperature of CPB. (Normothermal group: 37°C, Hypothermal group: 32°C) In both groups, the assistant CPB time after aortic declamp, the use of cardioversion that meaned the spontaneous recovery to sinus rhythm appeared or not, the dose of cathecholamines in- and post-operation, and the amounts of postoperative bleeding (after 6 h and 12 h) were compared as the clinical results and the data of CPK-MB, Myocin LC-II, and Troponin-T were measured as the effects of myocardial protection. The method of myocardial protection was the intermittent antegrade cold blood cardioplegia with terminal warm blood for all cases. As a result, the assistant CPB time after aortic declamp, the use of cardiovasion, and the amounts of postoperative bleeding (both of 6 h and 12 h) were less in normothermal group rather than in hypothermal group. (p<0.05). However we had no differences about the dose of cathecholamines in postoperation and the data of three items between two groups. So it suggests that the sufficient effects of myocardial protection could be obtaind in normothermal CPB as in hypothermal CPB. Therefore we conclude that normothermal CPB could provide some clinical advantages, such as shortening CPB time, recovery of sinus rhythm, and prevention of postoperative bleeding, compared to hypothermal CPB and sufficient myocardial protection.
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Yau TM, Carson S, Weisel RD, Ivanov J, Sun Z, Yu R, Glynn MF, Teasdale SJ: The effect of warm heart surgery on postoperative bleeding. J Thorac Cardiovasc Surg 103: 1155–1163, 1992
43:1595–1599, 1995
45: 679–681, 1997
Lazenby WD, Ko W, Zelano JA, Levowitz N, Shin YT, Isom OW, Kreiger KH: Effects of tempareture and flow rate on regional blood flow and metabolism during cardiopulmonary bypass. Ann Thorac Surg 53: 957–964, 1992
Singh AK, Feng WC, Bert AA, Rotenberg FA: Warm body, cold heart surgery. Eur J Cardiothorac Surg 7: 225–230, 1993
Continuous Warm Blood Cardioplegia 42: 991–996, 1994
Teoh KH, Christakis GT, Weisel RD, Fremes SE, Mickel DAG, Romaschin AD, Harding RS, Ivanov J, Madonik MM, Ross IM, Mclaughlin PR, Baird RJ: Accelerated myocardial metabolic recovery with terminal warm blood cardioplegia. J Thorac Cardiovasc Surg 91: 888–895, 1986
Christakis GT, Koch JP, Deemar KA, Fremes SE, Sinclair L, Chen E, Salerno TA, Goldman BS, Lichtenstein SV: A randomized study of the systemic effects of warm heart surgery. Ann Thorac Surg 54: 449–459, 1992
Buckberg GD: A proposed “solution” to the cardioplegic controversy. J Thorac Cardiovasc Surg 77: 808–815, 1979
Loop FD, Higgins TL, Panda R, Pearce G, Estafanous FG: Myocardial protection during cardiac operations. Decreased morbidity and lower cost with blood cardioplegia and coronary sinus perfusion. J Thorac Cardiovasc Surg 104: 608–618, 1992
Landymore R, Marble A: Effect of hypothermia and cardioplegia on intramyocardial voltage and myocardial oxygen consumption. Can J Surg 32: 452–455, 1989
Blood Cardioplegia 43: 990–996, 1995
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Uno, Y., Horikoshi, S., Emoto, H. et al. Clinical advantages and myocardial protection of normothermal CPB —Comparison with hypothermal CPB—. Jpn J Thorac Caridovasc Surg 46, 671–676 (1998). https://doi.org/10.1007/BF03217801
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DOI: https://doi.org/10.1007/BF03217801