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Postoperative ventilatory and circulatory effects of heating after aortocoronary bypass surgery
Author(s) -
Joachimsson P. O.,
Nyström S. O.,
Tydén H.
Publication year - 1987
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1987.tb02618.x
Subject(s) - medicine , cardiopulmonary bypass , anesthesia , perfusion , ventilation (architecture) , surgery , cardiology , mechanical engineering , engineering
Twenty‐four patients with stable angina pectoris were studied after aortocoronary bypass surgery with hypothermic cardiopulmonary bypass (CPB). Twelve patients (radiant heat supply group) were rewarmed during CPB to a nasopharyngeal temperature of at least 38°C and a mean rectal temperature of 34.4°C. Postoperatively they received radiant heat supply from a thermal ceiling. In addition, a heating water mattress was used during the end of the operation and heated, humidified inspired gases were administered intra‐ and postoperatively. The other 12 patients (combination heat supply group) had the rewarming during CPB extended until the rectal temperature exceeded 36°C, but otherwise received the same treatment as the radiant heat supply group. The combination of extended rewarming during CPB and postoperative radiant heat supply significantly reduced oxygen uptake, carbon dioxide production and the required ventilation volumes during early recovery as compared with the values in the radiant heat supply group. The reduced metabolic demands were accompanied by lower cardiac index and oxygen delivery, which, however, were sufficient for adequate tissue perfusion as judged by the similarity in oxygen extraction and arterial base excess values in the two groups. The metabolic demands and ventilatory requirements were reduced to a level at which safe early extubation is possible.