Logo image
Back
Benefits and risks of maintaining normothermia during cardiopulmonary bypass in adult cardiac surgery: A systematic review
Journal article   Peer reviewed

Benefits and risks of maintaining normothermia during cardiopulmonary bypass in adult cardiac surgery: A systematic review

K.M. Ho and J.A. Tan
Cardiovascular Therapeutics, Vol.29(4), pp.260-279
2009
DOI: https://doi.org/10.1111/j.1755-5922.2009.00114.x
url
Free to Read *No subscription requiredView

Abstract

Cardiopulmonary bypass is associated with significant morbidities, and the ideal temperature management during cardiopulmonary bypass remains uncertain. This review assessed the benefits and risks of maintaining normothermia during cardiopulmonary bypass in adult cardiac surgery. A total of 6731 patients from 44 randomized controlled trials in 14 countries, comparing normothermic (>34°C) and hypothermic (≤34°C) cardiopulmonary bypass in cardiac surgery (>18 years of age), were identified from MEDLINE (1966 to August 10, 2009), EMBASE (1988 to August 10, 2009), and Cochrane controlled trials register and subject to meta-analysis. Two investigators examined all studies and extracted the data independently. Mortality after normothermic and hypothermic bypass was not significantly different (1.4% vs. 1.9% respectively, relative risk [RR] 1.38, 95% confidence interval [CI] 0.94-2.04, I 2= 0%, P= 0.10). Hypothermic bypass was, however, associated with an increased risk of allogeneic red blood cells (RR 1.19, 95% CI 1.07-1.34, I 2= 0%, P= 0.002), fresh frozen plasma (RR 1.54, 95% CI 1.06-2.24, I 2= 7.7%, P= 0.02), and platelet transfusion (RR 2.53, 95% CI 1.26-5.06, I 2= 44%, P= 0.009). The risk of stroke, cognitive decline, atrial fibrillation, use of inotropic support or intra-aortic balloon pump, myocardial infarction, all-cause infections, and acute kidney injury after cardiac surgery was not significantly different between the two groups. The differences in the bypass time and targeted perfusion temperature were not significantly related to the risk of mortality and stroke. The current evidence suggests that maintaining normothermia during cardiopulmonary bypass in adult cardiac surgery is as safe as that of hypothermic surgery, and associated with a reduced risk of allogeneic blood transfusion.

Details

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: InCites

Metrics

23 Record Views
57 Times Cited - Web of Science

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types
Domestic collaboration
Citation topics
1 Clinical & Life Sciences
1.154 Assisted Ventilation
1.154.1403 Delirium
Web Of Science research areas
Cardiac & Cardiovascular Systems
Pharmacology & Pharmacy
ESI research areas
Pharmacology & Toxicology
Logo image