Mild Hypothermia May Offer Some Improvement to Patients with MODS after CPB Surgery

Abstract

OBJECTIVE:To summarize the effect of mild hypothermia on function of the organs in patients with multiple organ dysfunction syndrome after cardiopulmonary bypass surgery.METHODS:The patients were randomly divided into two groups, northermia group (n=71) and hypothermia group (n=89). We immediately began cooling the hypothermia group when test results showed multiple organ dysfunction syndrome, meanwhile all patients of two groups were drawn blood to test blood gas, liver and kidney function, blood coagulation function, and evaluated the cardiac function using echocardiography from 12 to 36 hours. We compared the difference of intra-aortic balloon pump, extracorporeal membrane oxygenation rate and mortality within one month after intensive care unit admission.RESULTS:Among the 160 patients, 36 died, 10 (11.24%) patients were from the hypothermia group and 26 (36.6%) from the northermia group (P <0.05). In northermia group, 45 (63.38%) patients used intra-aortic balloon pump and 4 (5.63%), extracorporeal membrane oxygenation; in hypothermia group, 35 (39.32%) patients used intra-aortic balloon pump and 2 (2.25%), extracorporeal membrane oxygenation（ P <0.05). The patients' heart rate decreased significantly in the hypothermia group. The heart rate of hypothermia group is significantly slower than the northermia group at the 36th hour (P <0.05). But the mean arterial pressure of hypothermia group is significantly higher than the northermia group at the 36th hour (P <0.05). In hypothermia group, PO2, SvO2 and lactate were improved significantly compared to pre-cooling (P <0.05), and they were significantly better than the northermia group at the 36th hour (P <0.05%). Prothrombin time and activated partial thromboplastin time have no significantly difference between the two groups (P >0.05). But the platelet count has significantly difference between the two groups at the 36th hour (P <0.05). The aspartate transaminase, alanine transaminase and creatinine were improved significantly in the hypothermia group, and they were significantly better than the northermia group (P <0.05).CONCLUSION:Mild hypothermia is feasible and safe for patients with multiple organ dysfunction syndrome after cardiopulmonary bypass surgery.

Red cell distribution width as a predictor multiple organ dysfunction syndrome in patients undergoing heart valve surgery

“…In the available literature, information on the risk factors of postoperative MODS in patients undergoing heart surgery is limited. Among these factors, preoperative NYHA functional class, prolonged mechanical ventilation, perioperative hypoxia, time of aortic cross-clamping, older age, surgery on cardiac arrest, severe left ventricular dysfunction and elevated value of creatinine are the most frequently described ( Yuan et al, 2018 ; Litwiński et al, 2018 ; Fernandez-Zamora et al, 2018 ; Yeung et al, 2016 ; Zhao et al, 2016 ; Eremenko and Minbolatova, 2015 ; Belletti et al, 2017 ).…”

The multivariable prognostic models for severe complications after heart valve surgery

“…Postoperative MODS is a common final cause to death in critically ill patients, the mortality is approximately 54% [ 15 , 31 , 48 , 49 ]. In most cases, patients with MODS are supported by continuous vasoactive agents or mechanism assistances to maintain vital signs [ 50 ]. The nature of MODS focuses on the crosstalk among different organs, damage from one organ could induce secondary injury for another organ, finally active a vicious circle [ 51 ].…”