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Anesth Analg 2006;103:1373-1379
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000242535.02571.fa

CARDIOVASCULAR ANESTHESIA

Temperature During Cardiopulmonary Bypass: The Discrepancies Between Monitored Sites

Nancy A. Nussmeier, MD*{dagger}, Weiping Cheng, MD{ddagger}, MariaRosa Marino, MD§, Tyler Spata, BS*, Shu Li, MD*, Gaile Daniels*, Trevor Clark, AS*, and William K. Vaughn, PhD||

From the *Division of Cardiovascular Anesthesiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas; {dagger}Department of Anesthesiology, Baylor College of Medicine, Houston, Texas; {ddagger}Department of Anesthesiology, Fu Wai Cardiovascular Hospital and Peking Union Medical College, Beijing, China; §Department of Anesthesia and Intensive Care, IRCCS Centro Cardiologico Monzino, Milan, Italy; and ||Division of Biostatistics and Epidemiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas.

Address correspondence and reprint requests to Dr. Nancy Nussmeier, Department of Anesthesiology, SUNY Upstate Medical University, 750 E. Adams Street, Syracuse, NY 13210. Address e-mail to: nussmein{at}upstate.edu.

We performed studies in patients to determine whether temperature recordings from sites commonly monitored during hypothermic cardiopulmonary bypass adequately reflect cerebral temperature. In Study I (n = 12), temperatures monitored in the jugular bulb (JB) were compared with those recorded in the nasopharynx, esophagus, bladder, and rectum. In Study II (n = 30), temperature was also monitored in the arterial outlet of the membrane oxygenator. A calibrated recorder continuously and simultaneously recorded all temperatures. Study I found large temperature discrepancies between the JB and all other body sites during cooling and rewarming. There was considerable interindividual variability in the degree of discrepancy between the JB and other sites. Study II produced similar results but also showed that JB temperature reached equilibration with the temperature of blood entering the patient via the arterial outlet of the membrane oxygenator after cooling for 3.3 ± 1.3 min and after rewarming for 16.5 ± 5.5 min. Analysis of variance revealed that this arterial outlet site had the smallest average discrepancy of all temperature sites relative to the JB site (P < 0.001). In summary, temperatures measured in body sites over-estimated JB temperature during cooling and under-estimated it during rewarming, whereas arterial outlet blood temperature provided a good approximation.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.