Changes in body temperature during profound hypothermic cardiopulmonary bypass in adult patients undergoing aortic arch reconstruction

Abstract

During induction of profound hypothermia and its reversal on total CPB with the heart in situ, a PA catheter thermistor, presumably because of its placement immediately behind the superior vena cava, would provide a reliable measure of the mixed venous blood temperature. During stabilized profound hypothermia, PAT, NPT, and FHT, but not UBT, serve as a reliable index of core temperature.

Novel Zero-Heat-Flux Deep Body Temperature Measurement in Lower Extremity Vascular and Cardiac Surgery

“…Using the latter device, the zero-heat-flow temperature lagged behind both nasopharyngeal and PA temperatures during cooling and rewarming phases of CPB. 31,32 On the other hand, the difference may have been due to deeper hypothermia of less than 201C in the studies applying the Terumo device. In addition, the authors of the study presented here detected poor agreement between the SpotOn and nasopharyngeal temperatures at temperatures below 321C in the patient undergoing deeper hypothermia.…”

“…In elective surgery a urinary bladder catheter is inserted only after the patient is anesthetized. Furthermore, the bladder temperature lags behind rapid changes 19,31 and might depend on the amount of urinary excretion. 34 In the study presented here, bladder temperature deviated from the primary core temperatures, considered to indicate heart and brain heat balance, at the beginning of the surgeries and during rapid changes during CPB.…”

Difference Between Bladder and Esophageal Temperatures in Mild Induced Hypothermia

“…Bladder, rectum, and esophagus are proposed (1). There have been reports, mostly from elective surgical patients, that bladder and rectum sites do not reflect real-time temperature changes when hypothermia is induced, and that temperature changes in these sites lag behind core body temperature changes (5)(6)(7)(8)(9). So far, there is little information on which temperature measuring site is closest to temperature changes measured invasively in patients where hypothermia is induced after cardiac arrest (5,10).…”

Reliability of different body temperature measurement sites during aortic surgery

“…Akata, et al have, furthermore, demonstrated that pulmonary artery temperatures closely reflect changes in brain temperatures, but nasopharyngeal/oesophageal measurements could not be considered as a reliable index of brain temperature, at all, during rapid induction of moderate/deep hypothermia. 36 Our study has some important limitations. It is an observational, retrospective study without randomisation and presents preliminary experience with a small number of patients.…”