The effects of two rewarming strategies on heat balance and metabolism after coronary artery bypass surgery with moderate hypothermia

Hanhela, R; Mustonen, Aki; Korhonen, Ilkka; Salomäki, Timo

doi:10.1034/j.1399-6576.1999.431003.x

Cited by 20 publications

(13 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eshel, in a rat model of TH, showed how rapid rewarming from moderate hypothermia is associated with more acute hemodynamic alterations compared with slow rewarming [25]. Similar effects were described in humans [26] and pediatric patients [27] undergoing TH for hypoxic ischemic encephalopathy and deep intraoperative hypothermia (27°C), respectively, as well as in the work of Hanhela and colleagues [28] on adults undergoing cardiopulmonary bypass for cardiac surgery.…”

Section: Hemodynamics and Imbalance In Oxygen Consumption And Deliverymentioning

confidence: 75%

Rewarming: facts and myths from the systemic perspective

2012

View full text Add to dashboard Cite

Section: Hemodynamics and Imbalance In Oxygen Consumption And Deliverymentioning

confidence: 75%

Rewarming: facts and myths from the systemic perspective

2012

View full text Add to dashboard Cite

“…Using this simple 4‐point scale, patients with the lowest CA category (I) had expected survival to discharge of ≈80% (60% with good neurologic outcome) as opposed to category IV patients who had survival <10% (<5% with good neurologic outcome). In patients who had paired arterial and superior vena cava central venous blood gases available within 30 minutes of one another, arteriovenous oxygen (A‐VO 2 ) and carbon dioxide (A‐VCO 2 ) gradients were calculated as they have been shown to correlate with cardiac output and metabolic energy expenditure . These were obtained as we hypothesized that higher heat generation was the result of higher metabolic rate and thus carbon dioxide generation presumably due to a higher hypothalamic/pituitary mediated set point.…”

Section: Methodsmentioning

confidence: 99%

“…These were obtained as we hypothesized that higher heat generation was the result of higher metabolic rate and thus carbon dioxide generation presumably due to a higher hypothalamic/pituitary mediated set point. Both arteriovenous oxygen and carbon dioxide gradients have been demonstrated to correlate with cardiac output but only carbon dioxide differences correlate with metabolism and heat generation …”

Section: Methodsmentioning

confidence: 99%

“…In patients who had paired arterial and superior vena cava central venous blood gases available within 30 minutes of one another, arteriovenous oxygen (A-VO 2 ) and carbon dioxide (A-VCO 2 ) gradients were calculated as they have been shown to correlate with cardiac output and metabolic energy expenditure. 25,26 These were obtained as we hypothesized that higher…”

Section: Additional Data Collectionmentioning

confidence: 99%

See 1 more Smart Citation

Determinants of Heat Generation in Patients Treated With Therapeutic Hypothermia Following Cardiac Arrest

Murnin

Sonder

Janssens

et al. 2014

JAHA

View full text Add to dashboard Cite

BackgroundTherapeutic hypothermia (TH) is recommended to reduce ischemic brain injury after cardiac arrest. The variables that predict heat generation by patients receiving TH are uncertain, as is how this heat generation relates to neurologic outcome. We hypothesized that patient characteristics, medication use, inflammation, and organ injury would be associated with heat generation. We further hypothesized that neurologic outcome would be most strongly associated with heat generation.Methods and ResultsSurface and intravascular cooling devices were used to provide TH in 57 consecutive cardiac arrest patients. Device water temperatures during the maintenance (33°C) phase were collected. Patient heat generation was quantified as the “heat index” (HI), which was the inverse average water temperature over a minimum of 2 hours of maintenance hypothermia. Variables measuring reduced ischemic injury and improved baseline health were significantly associated with HI. After controlling for presenting rhythm, a higher HI was independently associated with favorable disposition (OR=2.2; 95% CI 1.2 to 4.1; P=0.014) and favorable Cerebral Performance Category (OR=1.8; 95% CI 1.0 to 3.1; P=0.035). Higher HI predicted favorable disposition (receiver‐operator area under the curve 0.71, P=0.029). HI was linearly correlated with arteriovenous CO2 (r=0.69; P=0.041) but not O2 (r=0.13; P=0.741) gradients.ConclusionsIn cardiac arrest patients receiving TH, greater heat generation is associated with better baseline health, reduced ischemic injury, and improved neurologic function, which results in higher metabolism. HI can control for confounding effects of patient heat generation in future clinical trials of rapid TH and offers early prognostic information.

show abstract

“…A more extreme hypothermia is often caused by low or zero flow required to provide a clear surgical view. During the postoperative period, hypothermia has harmful effects, such as vasoconstriction and shivering (7). Rewarming to normal temperatures when the surgery is complete determines the success of the operation.…”

Section: Discussionmentioning

confidence: 99%

The Rewarming Index Formula for Pediatric Cardiopulmonary Perfusion

et al. 2009

View full text Add to dashboard Cite

Careful rewarming of perfusion blood following cardiopulmonary bypass surgery is critical to a successful outcome, but the optimal rewarming strategy is not clear. The purpose of this study was to derive a formula for a rewarming index (defined as [rewarming time x perfusion flow]/[body weight x body surface area]) that would enable the calculation of the ideal rewarming conditions for pediatric cardiopulmonary perfusion. We retrospectively investigated 220 pediatric cardiopulmonary bypass operations conducted from July 2005 to June 2008 in Okayama University Hospital, Japan. We determined the formula as Phi = (T x Q)/(R x S) = |0.9127P - 0.0152|, where Phi = rewarming index, T = rewarming time (min), Q = perfusion volume (L), R = body weight (kg), S = body surface area (m(2)), and P = temperature gap (right angle). The formula will help those who perform pediatric cardiopulmonary bypass surgery to establish ideal perfusion flow conditions and to control physiological temperature during rewarming.

show abstract

The effects of two rewarming strategies on heat balance and metabolism after coronary artery bypass surgery with moderate hypothermia

Cited by 20 publications

References 25 publications

Rewarming: facts and myths from the systemic perspective

Rewarming: facts and myths from the systemic perspective

Determinants of Heat Generation in Patients Treated With Therapeutic Hypothermia Following Cardiac Arrest

The Rewarming Index Formula for Pediatric Cardiopulmonary Perfusion

Contact Info

Product

Resources

About