Temperature monitoring during cardiopulmonary bypass?do we undercool or overheat the brain?*1

Kaukuntla, Hemanth; Harrington, Deborah; Bilkoo, Inderaj; Clutton-Brock, Tom; Jones, Timothy J.; Bonser, Robert S.

doi:10.1016/j.ejcts.2004.05.004

Cited by 51 publications

(37 citation statements)

References 24 publications

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“…The adequate temperature monitoring sites provide optimal estimation of intracerebral temperature [11]. T Naso reflects the carotid artery temperature, and is one of the most optimal surrogates of cerebral temperature because of the easy access and limited risk [12]. However, monitoring T Naso is unable to estimate left and right carotid artery temperature separately.…”

mentioning

confidence: 99%

The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass: clinical report

et al. 2011

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We evaluated the usefulness of a novel earphone-type infrared tympanic thermometer (IRT) during cardiac surgery with cardiopulmonary bypass. Tympanic membrane temperature (T(Tym)) was monitored using the IRT inserted into the right ear canal of 12 adult patients (ASA III) who had been scheduled for elective cardiac surgery with cardiopulmonary bypass under general anesthesia. Rectum (T(Rec)) and nasopharyngeal temperatures (T(Naso)) were also monitored, and all temperatures were recorded at 5-min intervals during cardiopulmonary bypass. Operating room temperature was kept at 20°-27°C; a conductive warming/cooling system was used to control the patient's body temperature. Of 265 measurements obtained, body temperature range was 31.6°-37.6°C. No complications were related to site of insertion of the monitoring probe. Significant correlations were seen between T(Tym) and T(Naso) (r = 0.971, P < 0.001), and T(Tym) and T(Rec) (r = 0.759, P < 0.001). A Bland-Altman plot showed that average temperature of T (Tym) was 0.06°C above T(Naso) (±0.66°C, 2 SD) and 0.12°C below T(Rec) (±1.78°C, 2 SD). We conclude that an earphone-type IRT is noninvasive and hygienic and could continuously evaluate selective cerebral temperature during cardiopulmonary bypass in adults.

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mentioning

confidence: 99%

The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass: clinical report

et al. 2011

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“…Conventional monitoring sites may not reflect the core brain temperature. Kaukuntla et al compared jugular bulb venous temperatures during deep hypothermic circulatory arrest and normothermic bypass with nasopharyngeal, arterial inflow, oesophageal, venous return, bladder and orbital skin temperatures [75]. It was found that during rewarming, all peripheral sites underestimated brain temperature.…”

Section: Temperature Monitoring For Brain Coolingmentioning

confidence: 98%

Cooling strategies and transport theories for brain hypothermia resuscitation

Jing

2007

Front. Energy Power Eng. China

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The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen. Unlike skeletal muscles that can survive for hours without oxygen, neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency. With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest, an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain. Meanwhile, the cooling function of the blood flow on the hot tissue will be stopped, while metabolic heat generation in the tissues still keeps running for awhile. Under such adverse situations, the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands. The reason can be attributed to the decreased metabolic requirements of the cold brain tissues, which allows a longer duration for the brain to endure reduced oxygen delivery. It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines, especially in cerebral damage, anoxia, circulatory arrest, respiratory occlusion, etc. However, although brain cooling has been found uniquely significant in clinical practices, the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation. Compared with the expanded trials in clinics, only very limited efforts were made to probe the engineering issues involved, which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation. From the viewpoint of biothermal medical engineering, the major theories and strategies for administering brain cooling can generally be classified into three categories: heat transfer, oxygen transport and cooling strategy. Aiming to provide a complete overview of the brain hypothermia resuscitation, this article comprehensively summarizes the recent progresses made in theoretical, practical and experimental techniques in the area. Particularly, attention is paid to the mathematical models to quantify the heat and oxygen transport inside the cerebral tissues. Typical cooling strategies to effectively lower brain temperature and thus decrease oxygen consumption rate in the cerebral tissues are analyzed. Approaches to deliver oxygen directly to the target tissues are discussed. Meanwhile, some future efforts worth pursuing within the area of brain cooling are suggested.

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“…Avoidance of cerebral hyperthermia in the setting of CPB has been promoted to avoid cerebral injury [10,12,[20][21][22]. Scheffer and Sanders [10] (2003) highlight that although the independent relationship between cerebral hyperthermia during CPB and neurologic injury has not been unequivocally proven, sufficient and compelling indirect evidence supports extreme caution.…”

Section: Avoidance Of Hyperthermiamentioning

confidence: 98%

“…In 2004, Kaukuntla and colleagues [12] demonstrated that commonly used core temperature monitoring sites (bladder, esophageal, and NP) were not accurate measures of cerebral temperature where JB temperature is used as the gold standard. The authors concluded that arterial outlet temperatures should be monitored to avoid cerebral hyperthermic inflow.…”

Section: Optimal Site For Temperature Measurementmentioning

confidence: 98%

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass—Temperature Management During Cardiopulmonary Bypass

Engelman

Baker

Likosky

et al. 2015

The Annals of Thoracic Surgery

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Temperature monitoring during cardiopulmonary bypass?do we undercool or overheat the brain?*1

Cited by 51 publications

References 24 publications

The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass: clinical report

The usefulness of an earphone-type infrared tympanic thermometer during cardiac surgery with cardiopulmonary bypass: clinical report

Cooling strategies and transport theories for brain hypothermia resuscitation

The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass—Temperature Management During Cardiopulmonary Bypass

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