Normothermia versus hypothermia during cardiopulmonary bypass: A randomized, controlled trial

Tönz, Martin; Mihaljević, Tomislav; Segesser, Ludwig K. von; Schmid, Edith R.; Doller-Jemelka, Helen I.; Pei, P.; Turina, Marko

doi:10.1016/0003-4975(94)00718-m

Cited by 97 publications

(35 citation statements)

References 23 publications

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“…This confirms previous findings suggesting that inducing hypothermia reduces cardiac output and increases SVR because of vasoconstriction of arterioles, explaining why MAP often remains unaffected or slightly elevated. 5,22,23 Our protocol for targeting MAP (≥65 mm Hg) and CVP (10-15 mm Hg) are consistent with current guideline recommendations, but should be acknowledged when interpreting the results of the present study.…”

Section: Discussionsupporting

confidence: 76%

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Bro-Jeppesen

Hassager

Wanscher

et al. 2014

Circ: Cardiovascular Interventions

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emodynamic instability with low cardiac output and low to normal filling pressures is frequent in survivors after out-of-hospital cardiac arrest (OHCA), but may not always be apparent at hospital admission. 1 The hemodynamic profile suggestive of myocardial stunning and vasodilation is part of the postcardiac arrest syndrome, characterized by impaired vasoregulation, reduced cardiac output, and hypotension, which all contribute to decreased organ perfusion.2 Although application of targeted temperature management (TTM) in comatose survivors after OHCA is an established part of postresuscitation care, its effects on central hemodynamics may pose additional challenges to the treating physicians. Our current knowledge of the hemodynamic implications of TTM is limited because most descriptive studies are small or used noninvasive methods for hemodynamic evaluation, 3,4 whereas other studies were primarily designed for evaluating outcome. 5,6 A recent large randomized study, the Target Temperature Management after Cardiac arrest trial (TTM Trial), compared the beneficial effects of a target temperature of 33°C compared with 36°C after OHCA. Both regimens were equally efficacious in terms of mortality (50% versus 48%; P=0.51) and unfavorable neurological outcome (54% versus 52%; P=0.78). 7This study reports the impact on central hemodynamics in survivors after OHCA randomized to a TTM at 33°C or 36°CBackground-Cardiovascular dysfunction is common after out-of-hospital cardiac arrest as part of the postcardiac arrest syndrome, and hypothermia may pose additional impact on hemodynamics. The aim was to investigate systemic vascular resistance index (SVRI), cardiac index, and myocardial performance at a targeted temperature management of 33°C (TTM33) versus 36°C (TTM36

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Section: Discussionsupporting

confidence: 76%

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Bro-Jeppesen

Hassager

Wanscher

et al. 2014

Circ: Cardiovascular Interventions

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“…However, following successful reports of normothermic CPB [5] there was an increased use of warm heart surgery techniques. Normothermic bypass has been shown to have various systemic advantages including increased cardiac output [6], improved myocardial function [7], reduced bleeding complications [8], shorter time to extubation and length of hospital stay. However, along with these advantages, there have been reports of increased incidence of adverse neurological events in warm bypass groups [9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Various benefits have been reported, including increased cardiac output [6], improved myocardial function [7], reduction in respiratory demand, reduced bleeding and reduced time to extubation [8]. However, with these benefits came concerns of increased incidence of neurological deficits [9,10].…”

Section: Introductionmentioning

confidence: 98%

Differential brain and body temperature during cardiopulmonary bypass?a randomised clinical study*1

Kaukuntla

Walker

Harrington

et al. 2004

European Journal of Cardio-Thoracic Surgery

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“…Surgical procedures included coronary artery bypass graft surgery (CABG), aortic valve replacement, mitral valve replacement or repair or combination of CABG and valve surgery. Most patients were operated on-pump, with normothermic cardiopulmonary bypass [13]. Myocardial protection was ensured by continuous retrograde tepid blood (24°C) cardioplegia [14].…”

Section: Patients' Selection and Study Designmentioning

confidence: 99%

Atrial flutter after non-congenital cardiac surgery: Incidence, predictors and outcome

Fatemi¹,

Leledy²,

Gal³

et al. 2011

International Journal of Cardiology

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Normothermia versus hypothermia during cardiopulmonary bypass: A randomized, controlled trial

Cited by 97 publications

References 23 publications

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest

Differential brain and body temperature during cardiopulmonary bypass?a randomised clinical study*1

Atrial flutter after non-congenital cardiac surgery: Incidence, predictors and outcome

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