Hypothermic Versus Normothermic Cardiopulmonary Bypass in Patients With Valvular Heart Disease

Open Heart Surgery at Patient’s Own Temperature Without Active Cooling

“…Despite tissue protection benefits, it is difficult to determine the effect of hypothermia on mortality and morbidity due to other metabolic problems that occur. Recent studies have reported that hypothermia achieved by active cooling in cardiac surgery is not superior to mild hypothermia or normothermia in terms of complication rates [Lomivorotov 2014;Mackowiak 1992]. Similarly, there was no statistically significant difference for drainage, all causes of infection, renal insufficiency, postoperative MI, and mortality rates between the groups in our study.…”

“…Cardiac surgery can be performed under CPB without the need for hypothermia with decent myocardial protection (intermittent blood cardioplegia perfusion, left ventricular venting, short CCs). In a study by Lomivorotov et al, cardiac troponin levels were compared between hypothermic and normothermic CPB patients, and no significant difference was found between the two [Lomivorotov 2014].…”

Cold agglutinins in a patient undergoing normothermic cardiac operation with warm cardioplegia

“…Physicians have tried to determine the best CPB temperature management, and contraindicated outcomes between normothermic and hypothermic CPB operations have been reported. [13][14][15] According to the Clinical Practice Guidelines for Temperature Management during CPB, 16 surgical teams should limit the CPB temperature to <37°C to avoid cerebral hyperthermia (class I, level C), and temperature gradients between the arterial outlet and venous inflow should not exceed <10°C to avoid generation of gaseous emboli (class I, level C). No unified agreements have been reached on this difficult topic in the normal population.…”

Successful management of hypothermic cardiopulmonary bypass in a malignant hyperthermia susceptible patient

“…There was no significant difference in Troponin I levels between the groups. [ 42 ] Accurate diagnosis of an MH during CPB requires a high index of suspicion and close monitoring of surrogate markers of MH such as peripheral mottling, cyanosis and sweating. [ 21 ] Specifically, in patients who are at high risk for MH, it may be prudent to maintain normothermia during CPB.…”