Pulmonary artery blood temperature at admission to the intensive care unit is predictive of outcome after on‐pump coronary artery bypass surgery

Lahtinen, Jarmo; Biancari, Fausto; Ala‐Kokko, Tero; Rainio, Pekka; Salmela, Esa; Pokela, Risto; Satta, Jari; Lepojärvi, Martti; Juvonen, Tatu

doi:10.1080/14017430410028500

Cited by 6 publications

(7 citation statements)

References 45 publications

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“…In our ten years of experience, delayed hypothermia called our attention in patients who required re-exploration because of bleeding where its source could not be identified. A study performed by Lahtinen et al encouraged us to do this study as the authors reported a correlation between volume of postoperative bleeding and low pulmonary artery temperatures [5]. Nathan et al reported that the depth of hypothermia is an important parameter for postoperative bleeding [6].…”

Section: Discussionmentioning

confidence: 99%

<![CDATA[<B>Can skin temperature be a clue for predicting excessive postoperative bleeding?</B>]]>

Manduz¹,

Toktamis²,

Sapmaz³

et al. 2006

Braz. j. cardiovasc. surg.

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Section: Discussionmentioning

confidence: 99%

<![CDATA[<B>Can skin temperature be a clue for predicting excessive postoperative bleeding?</B>]]>

Manduz¹,

Toktamis²,

Sapmaz³

et al. 2006

Braz. j. cardiovasc. surg.

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“…These conflicting results may be attributable to the fact that the previous studies only used a single measurement of temperature upon arrival at the ICU and that patient management was not according to a standardized protocol 10,11,28. In addition, a recent study involving the largest cohort of cardiac surgical patients depicted that transient hypothermia was not associated with adverse outcome 29.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the temporal continuity, intraoperative temperatures essentially influence the temperature upon ICU arrival, and only the latter had been validated in most of the previous studies 10,11,28. Postoperative persistent hypothermia may affect bleeding as well, however, it was not possible to address this relationship, as all of the patients were normothermic within 2 hr after the surgery.…”

Section: Discussionmentioning

confidence: 99%

The Influence of Hypothermia on Transfusion Requirement in Patients Who Received Clopidogrel in Proximity to Off-Pump Coronary Bypass Surgery

et al. 2014

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PurposeHypothermia adversely affects the coagulation that could be of clinical significance in patients receiving clopidogrel. We evaluated the influence of hypothermia on transfusion requirements in patients undergoing isolated off-pump coronary artery bypass surgery (OPCAB) who continued clopidogrel use within 5 days of surgery.Materials and MethodsProtocol-based, prospectively entered data of 369 patients were retrospectively reviewed. The time-weighted average of intraoperative temperatures and the temperature upon ICU admission (TWA-temp) was assessed. Patients were divided into normothermia (≥36℃, n=224) and hypothermia (<36℃, n=145) group. The transfusion requirement for perioperative blood loss was assessed and compared.ResultsPatients with hypothermia were older and had lower body surface area (BSA) than patients with normothermia. Age and BSA adjusted transfusion requirement was significantly larger in the hypothermia group [patients requiring transfusion: 64% versus 48%, p=0.003; number of units: 0 (0-2) units versus 2 (0-3) units, p=0.002]. In multivariate analysis of predictors of perioperative multiple transfusion requirements, hypothermia was identified as an independent risk factor along with age, female gender, BSA, chronic kidney disease, and congestive heart failure.ConclusionHypothermia was associated with increased transfusion requirement in patients undergoing OPCAB who received clopidogrel in proximity to surgery. Considering the high prevalence and the possibility of hypothermia being a modifiable risk factor, aggressive measures should be undertaken to maintain normothermia in those patients.

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“…A study performed by Lahtinen et al encouraged us to do this study as the authors reported a correlation between volume of postoperative bleeding and low pulmonary artery temperatures [5]. Nathan et al reported that the depth of hypothermia is an important parameter for postoperative bleeding [6].…”

Section: Discussionmentioning

confidence: 99%

“…We can not say this definitively as many reasons, such as low cardiac output, can cause coagulation deficits [5]. We did not measure the cardiac output as this is not routine in our service and thus was not recorded on patients' records and this is a retrospective study.…”

Section: Discussionmentioning

confidence: 99%

A temperatura da pele pode ser um indicador para hemorragia grave no pós-operatório?

Manduz¹,

Toktamis²,

Sapmaz³

et al. 2006

Rev Bras Cir Cardiovasc

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A temperatura da pele pode ser um indicador para hemorragia grave no pós-operatório?Can skin temperature be a clue for predicting excessive postoperative bleeding? Abstract Objective: The purpose of this study was to investigate whether postoperative hypothermia evaluated by skin temperature can be a clue of excessive bleeding requiring re-exploration.Methods: In this retrospective study, the records of 12 patients who needed re-exploration due to bleeding in the postoperative period were reviewed and the time from the first minute in the intensive care unit until the skin temperature reached 36.5ºC was measured. Cardiopulmonary bypass (CPB) durations were noted as were preoperative and postoperative Activated Clotting Times (ACT) and the lowest body temperatures during the operation. A control group was formed of 16 randomly chosen patients who did not need reexploration with CPB times similar to the study group. All parameters were compared between the two groups using the SPSS software version 10.0.Results: The length of time from the first minute in the intensive care unit until skin temperatures reached 36.5ºC were significantly longer in the study group (p=0.0001). Preoperative and postoperative ACT were not significantly different (p=0.312 and p=0.576 respectively). The lowest body temperatures were also not significantly different (p=0.157).Conclusions: Our findings show that skin temperature is an important indicator of excessive bleeding with a need for re-exploration. Hypothermia may be a reason for this or may be a result of the bleeding. Braz J Cardiovasc Surg 2006; 21(4): 429-432 INTRODUCTION Postoperative bleeding is a serious problem for all patients undergoing heart surgery. Bleeding is increased in patients exposed to cardiopulmonary bypasses [1]. There are many causes for bleeding in patients who are exposed to cardiopulmonary bypasses, which include coagulation factor loss, hemodilution, platelet loss and platelet function deficiency, hypothermia, immune response of host to the effects of heparin and protamine and inadequate surgical homeostasis [2]. Because of inadequate re-warming of body temperature, patients who undergo heart surgery associated with hypothermia are often still hypothermic after admission to the intensive care unit [3]. Some patients require re-exploration because of bleeding in the early postoperative period. Frequently the surgical source of bleeding can not be identified [1][2][3][4]. These re-explored patients may only be effectively offered control of bleeding [4]. The purpose of this study is to evaluate residual hypothermia and its duration and whether delayed hypothermia might be associated to excessive bleeding. Descriptors METHOD PatientsThis is a retrospective review of 721 patients undergoing elective heart surgery involving coronary artery bypass, valve surgery and combined procedures. Records of patients treated from March 1995 to March 2005 in our clinic were reviewed with the approval of the Research Ethics Commission of Cumhuriyet University. A total o...

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Pulmonary artery blood temperature at admission to the intensive care unit is predictive of outcome after on‐pump coronary artery bypass surgery

Abstract: Patients having a PA temperature > or =36.4 degrees C at admission to the ICU after CABG seem to be at higher risk of poor postoperative outcome.

Cited by 6 publications

References 45 publications

<![CDATA[<B>Can skin temperature be a clue for predicting excessive postoperative bleeding?</B>]]>

<![CDATA[<B>Can skin temperature be a clue for predicting excessive postoperative bleeding?</B>]]>

The Influence of Hypothermia on Transfusion Requirement in Patients Who Received Clopidogrel in Proximity to Off-Pump Coronary Bypass Surgery

A temperatura da pele pode ser um indicador para hemorragia grave no pós-operatório?

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