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Oxygenation within the first 120 h following coronary artery bypass grafting. Influence of systemic hypothermia (32 °C) or normothermia (36 °C) during the cardiopulmonary bypass: a randomized clinical trial
Author(s) -
Rasmussen B. S.,
Sollid J.,
Rees S. E.,
Kjærgaard S.,
Murley D.,
Toft E.
Publication year - 2006
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.1399-6576.2006.00897.x
Subject(s) - medicine , cardiopulmonary bypass , oxygenation , hypothermia , anesthesia , artery , perfusion , cardiology , pulmonary shunt , shunt (medical) , cardiac surgery , hemodynamics
Background: Lung function is often impaired after cardiac surgery performed under cardiopulmonary bypass (CPB). Normothermic CPB has become more common, but it remains unknown whether it reduces post‐operative lung function compared with hypothermic CPB. The aim of this study was to investigate oxygenation within the first 120 h after systemic hypothermia and normothermia under CPB. Methods: Thirty patients undergoing coronary artery bypass grafting (CABG) were randomized to either hypothermic (32 °C) or normothermic (36 °C) CPB. Oxygenation was studied by a simple method for the estimation of intrapulmonary shunt and ventilation–perfusion (V/Q) mismatch pre‐operatively and 4, 48 and 120 h post‐operatively by changing F i o 2 in four to six steps. V/Q mismatch was described with Δ P o 2 (normal values, 0–2.38 kPa). Results: Shunt and V/Q mismatch (Δ P o 2 ) increased post‐operatively in both groups ( P < 0.01), with no differences between the groups, and with the nadir values 48 h after surgery, i.e. shunt of 15% (5.8–25%) and Δ P o 2 of 3.0 kPa (0.8–14 kPa) [values given as median (range)]. Conclusions: Impaired oxygenation is prevalent and prolonged following CABG, with equal intensity after hypothermic and normothermic CPB.