This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (11) Citing Articles via Google Scholar Google Scholar Articles by Thong, W. Y. Articles by Nussmeier, N. A. Search for Related Content PubMed PubMed Citation Articles by Thong, W. Y. Articles by Nussmeier, N. A. Related Collections Cardiovascular Heart

---

CARDIOVASCULAR ANESTHESIA

Hyperthermia in the Forty-Eight Hours After Cardiopulmonary Bypass

Weng Y. Thong, MD^*, Andrew G. Strickler, MS^*, Shu Li, MD^*, Elester E. Stewart, RN^*, Connie L. Collier, RN^*, William K. Vaughn, PhD, and Nancy A. Nussmeier, MD^*

Departments of *Cardiovascular Anesthesiology and Biostatistics and Epidemiology, Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston

Address correspondence and reprint requests to Nancy A. Nussmeier, MD, Department of Cardiovascular Anesthesiology, Texas Heart Institute, PO Box 20345, MC 1–226, Houston, TX 77225. Address e-mail to nnussmeier{at}heart.thi.tmc.edu

The adverse consequences of perioperative hypothermia have been emphasized. However, postoperative hyperthermia may be equally hazardous after cardiac surgery, owing to increased oxygen demand and potential exacerbation of neurologic injury. To determine the incidence of hyperthermia (bladder temperature [BT] 38.5°C) after cardiopulmonary bypass, we recorded hourly postoperative BT (n = 305), nasopharyngeal (n = 40), and jugular venous bulb (n = 20) temperatures for up to 48 h after admission to the intensive care unit (ICU). At least 38% of the patients developed postoperative hyperthermia, although all patients did not remain in the ICU for 48 h. The incidence of hyperthermia peaked with a bimodal distribution at 9.1 ± 4.0 h (26%) and at 27.7 ± 6.3 h (26%). Of these, 14% of the patients were hyperthermic at both times. For the first 5 postoperative h, jugular venous bulb temperature was 0.4°C higher than the BT (P < 0.05). There was no difference between BT and nasopharyngeal temperature. Higher temperature on ICU entry and age <60 yr were independently associated with hyperthermia (P < 0.05). In summary, postoperative hyperthermia is common, with both early and late occurrences during the first 48 h after cardiac surgery with cardiopulmonary bypass.

IMPLICATIONS:Postoperative hyperthermia is common in cardiac surgery patients, with a bimodal distribution during the first 48 h. Jugular venous bulb temperature is slightly higher than bladder temperature for several hours. Postoperative cerebral hyperthermia may contribute to the severity of cerebral injury after cardiopulmonary bypass.

This article has been cited by other articles:

				A. M. Grigore, C. F. Murray, H. Ramakrishna, and G. Djaiani A Core Review of Temperature Regimens and Neuroprotection During Cardiopulmonary Bypass: Does Rewarming Rate Matter? Anesth. Analg., December 1, 2009; 109(6): 1741 - 1751. [Abstract] [Full Text] [PDF]

				L. R. Hoover, R. Dinavahi, W.-P. Cheng, J. R. Cooper Jr, M. R. Marino, T. C. Spata, G. L. Daniels, W. K. Vaughn, and N. A. Nussmeier Jugular Venous Oxygenation During Hypothermic Cardiopulmonary Bypass in Patients at Risk for Abnormal Cerebral Autoregulation: Influence of {alpha}-Stat Versus pH-Stat Blood Gas Management Anesth. Analg., May 1, 2009; 108(5): 1389 - 1393. [Abstract] [Full Text] [PDF]

				G. S. Murphy, J. W. Szokol, J. H. Marymont, M. J. Avram, and J. S. Vender The Effects of Morphine and Fentanyl on the Inflammatory Response to Cardiopulmonary Bypass in Patients Undergoing Elective Coronary Artery Bypass Graft Surgery Anesth. Analg., June 1, 2007; 104(6): 1334 - 1342. [Abstract] [Full Text] [PDF]

				I. Dorotta, P. Kimball-Jones, and R. Applegate II Deep hypothermia and circulatory arrest in adults. Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2007; 11(1): 66 - 76. [Abstract] [PDF]

				C. W. Hogue Jr, C. A. Palin, and J. E. Arrowsmith Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices. Anesth. Analg., July 1, 2006; 103(1): 21 - 37. [Abstract] [Full Text] [PDF]

				G. N. Djaiani Aortic arch atheroma: stroke reduction in cardiac surgical patients. Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2006; 10(2): 143 - 157. [Abstract] [PDF]

				H. P. Grocott, H. M. Homi, and F. Puskas Cognitive Dysfunction After Cardiac Surgery: Revisiting Etiology Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2005; 9(2): 123 - 129. [Abstract] [PDF]

				H. Kaukuntla, D. Harrington, I. Bilkoo, T. Clutton-Brock, T. Jones, and R. S. Bonser Temperature monitoring during cardiopulmonary bypass--do we undercool or overheat the brain? Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 580 - 585. [Abstract] [Full Text] [PDF]

				S. Bar-Yosef, J. P. Mathew, M. F. Newman, K. P. Landolfo, H. P. Grocott, and The Neurological Outcome Research Group and C.A.R. Prevention of Cerebral Hyperthermia During Cardiac Surgery by Limiting On-Bypass Rewarming in Combination with Post-Bypass Body Surface Warming: A Feasibility Study Anesth. Analg., September 1, 2004; 99(3): 641 - 646. [Abstract] [Full Text] [PDF]