ABSTRACT

Objective:

To evaluate the effects of perfusion temperature on inflammatory response, and outcome in patients undergoing open heart surgery.

Methods:

Forty nine patients were assigned to 2 groups, group I (n=24) normothermic cardiopulmonary bypass (CPB) and group II (n=25) hypothermic CPB. Blood samples were collected preoperatively and postoperatively for interleukin-6 (IL6) and high sensitive CRP (hsCRP). Concerning the variables, there were no significant preoperative differences between the groups.

Results:

At the end of CPB, mean plasma levels of IL-6 was significantly lower in the normothermia group (Group 1: 34.0±14.9 vs. Group 2: 53.0±41. p<0.05). At postoperative 12h, IL6 concentrations were 25.2±9.2 in Group 1 and 34.0±21.2 in Group 2 (p>0.05). In 24 h, the IL-6 concentrations were 20.4±8.1 in Group 1 and 29.6±21.1 in Group 2 (p>0.05). High sensitive CRP levels were significantly higher at the end of CPB than the preoperative levels (Group 1: 16.1±3.4 vs. Group 2: 18.5±3.6, p<0.05). At postoperative 12 h and 24 h, hsCRP concentrations declined (Group 1: 12.8±2.6 vs. Group 2: 13.2±2.9 at 12h, p>0.05 and Group 1: 12.3±2.6 vs. Group 2: 14.2±2.8 at 24 h, p>0.05). Normothermic CPB resulted in a shorter CPB time; 63.1 ±19.1min. vs 82.0 ±19.2 min. (p <0.01) and the interval up to extubation was 8.9±2.5 h vs. 11.6±4.6 h (p<0.05). Blood loss was 633.1±390.4 ml vs. 981.8±438.0 ml (p<0.05) and use of blood was 2.7±0.7 packages vs. 4.2±0.5 packages (p<0.01) in Group 1 and Group 2 respectively, as well as the length of ICU stay 2.5±0.5 vs. 4.0±0.6 days, (p<0.01). Length of hospital stay was significantly shorter in the normothermic group 7.2±0.5 days vs. 8.0±0.6 days (p<0.01).

Conclusion:

A strategy of normothermic CPB seems to be as safe as hypothermic CPB and is associated with a reduced inflammatory response and offers a better outcome. (JAREM 2012; 2: 10-4)