Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Okano, Nobuhiro; Owada, Ryoichi; Fujita, Nao; Kikuchi, Yuji; Saito, Shigeru; Goto, Fumio

doi:10.1007/bf03018848

Cited by 15 publications

(11 citation statements)

References 16 publications

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“…Similar results were reported by Okano et al. [30]: S j o 2 < 50% within 40 min of the start of warm CPB (> 35 °C), but no change in S j o 2 in patients with mild hypothermic bypass (32 °C). However, the number of patients showing desaturation in each group was not mentioned.…”

Section: Jugular Bulb Oximetrysupporting

confidence: 90%

“… Poor cerebral oxygenation in some of the warm CPB studies can be attributed to continuous warming from the beginning of bypass to maintain bypass temperature > 35 °C or strictly at 37 °C [30, 31, 46]. This finding is supported by poor neurological outcomes in warm CPB studies that used continuous rewarming to keep bypass temperature > 35 °C [18, 19].…”

Section: Summary Of the Effects Of Warm Vs Cold Cardioplumonary Bypassmentioning

confidence: 99%

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Cardiopulmonary bypass temperature and brain function

2005

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A debate has emerged in recently published studies about the optimum cardiopulmonary bypass temperature for good neurological outcome - warm vs. cold, i.e. normothermic vs. hypothermic. Although many comparative studies have been performed, the results of these studies are inconclusive and are difficult to interpret. Brain function has been studied in terms of neurological and neuropsychological outcome, protein S100beta levels as a marker of brain damage, and cerebral oxygenation using jugular bulb oximetry and near-infrared spectroscopy. The studies produce no conclusive proof of the superiority of warm or cold cardiopulmonary bypass. However, it appears that any degree of bypass hypothermia (< 35 degrees C) may protect the brain. On the other hand, even a slight increase in bypass temperature to > 37 degrees C may cause marked brain injury.

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Section: Jugular Bulb Oximetrysupporting

confidence: 90%

Section: Summary Of the Effects Of Warm Vs Cold Cardioplumonary Bypassmentioning

confidence: 99%

Cardiopulmonary bypass temperature and brain function

2005

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“…It seems from the above studies that patients undergoing normothermic CPB are at greater risk of cerebral desaturation and hypothermic CPB may, therefore, be a wise choice for preservation of brain oxygenation. Similarly, Okano et al [62] reported periods of S j o 2 , 50% during warm CPB (. 35 8C), but no changes in S j o 2 in patients undergoing mild hypothermic bypass (32 8C).…”

Section: Specific Applications Of Jugular Bulb Oximetry During Cardiamentioning

confidence: 78%

Jugular bulb oximetry during cardiac surgery

Ali¹,

Harmer²,

Latto

2001

Anaesthesia

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Imbalance between cerebral oxygen supply and demand is thought to play an important role in the development of cerebral injury during cardiac surgery. This article presents an overview of cerebral oxygenation monitored by jugular bulb oximetry during cardiac surgery with cardiopulmonary bypass. The general principles of jugular bulb oximetry including physiology, intermittent and continuous monitoring, technical considerations, limitations and potential complications are discussed. Different applications of jugular bulb oximetry during bypass surgery and the possible therapeutic approaches to impaired cerebral oxygenation are described.

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“…Several studies have compared cerebral oxygenation during warm and cold CPB (9, 10, 22, 23). These studies used CPB temperature >35°C (9, 22, 23) or strictly at 37°C (10). The common findings of these studies were the presence of more patients who experienced desaturation periods with increased AjDO 2 early during warm CPB (10).…”

Section: Discussionmentioning

confidence: 99%

“…The reason for early impaired cerebral oxygenation during warm CPB in the previous studies (9, 10, 22, 23) was because patients were exposed to the risk of continuous rewarming from the beginning of CPB to keep bypass temperature at >35°C or strictly at 37°C. More importantly, there is an increased risk of undetected brain hyperthermia during rewarming because nasopharyngeal and oesophagyeal temperatures underestimate brain temperature (24–27).…”

Section: Discussionmentioning

confidence: 99%