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CARDIOVASCULAR ANESTHESIOLOGY

A Core Review of Temperature Regimens and Neuroprotection During Cardiopulmonary Bypass: Does Rewarming Rate Matter?

Alina M. Grigore, MD, MHS, FASE^*, Catherine Friederich Murray, BS, Harish Ramakrishna, MD, FASE^*, and George Djaiani, MD, DEAA, FRCA, FRCPC

From the Departments of *Anesthesiology, and Critical Care Medicine, Mayo Hospital, Phoenix, Arizona; and Department of Anesthesiology, Toronto General Hospital, University of Toronto, Toronto, Canada.

Address correspondence and reprint requests to Alina Grigore, MD, MHS, FASE, Department of Anesthesiology, Mayo Hospital, 5777 East Mayo Blvd., Phoenix, AZ 85054. Address e-mail to grigore.alina{at}mayo.edu.

Abstract

Despite a half century of research and the implementation of various risk-reduction strategies among clinicians and basic scientists, patients continue to experience strokes and cognitive dysfunction related to the use of cardiopulmonary bypass (CPB) for cardiac surgery. One strategy to reduce these detrimental effects has been the use of hypothermia. Although numerous studies have addressed the issue, the question of whether the use of hypothermia during CPB attenuates the impact of central nervous system consequences remains unresolved. However, data clearly demonstrate that hyperthermia is to be avoided in the perioperative period, necessitating careful rewarming strategies if hypothermia is used during CPB. Selecting and understanding the impact of the temperature-monitoring site is important to accurately estimate cerebral temperature and to avoid inadvertent surges in brain temperature. In this article, we review the literature regarding the impact of hypothermia and rewarming rates during cardiac surgery.

This article has been cited by other articles:

				D. J. Cook CON: Temperature Regimens and Neuroprotection During Cardiopulmonary Bypass: Does Rewarming Rate Matter? Anesth. Analg., December 1, 2009; 109(6): 1733 - 1737. [Full Text] [PDF]

				H. P. Grocott PRO: Temperature Regimens and Neuroprotection During Cardiopulmonary Bypass: Does Rewarming Rate Matter? Anesth. Analg., December 1, 2009; 109(6): 1738 - 1740. [Full Text] [PDF]