Original Article

The Effect of Temperature Management During Cardiopulmonary Bypass on Clinical Outcome in Pediatric Patients Undergoing Correction of Ventricular Septal Defect

¹ Department of Cardiothoracic Surgery, Rotterdam, The Netherlands
² Pediatric Cardiology, Rotterdam, The Netherlands
³ Anesthesiology, University Hospital, Rotterdam, The Netherlands

^* Address correspondence to: H.D. Golab, MSc, EKP Thoraxcentre, Bd 467 P.O. Box 2040 3000 CA Rotterdam, The Netherlands

Abstract

Moderate hypothermia of 28°C is widely accepted in cardiac surgery with cardiopulmonary bypass (CPB). Recently, however, several studies suggested that normothermic or “tepid” bypass techniques may improve the clinical outcome for patients undergoing cardiac operations.

To assess the effect of bypass temperature management strategy in pediatric patients undergoing correction of ventricular septal defect, 26 patients with body weight under 10 kg were randomly assigned to two treatment groups: Group 1, mild hypothermia, patients cooled to nasopharyngeal temperature of 32°C during the bypass; or Group 2, moderate hypothermia of 28°C. Clinical parameters were recorded, and blood samples were obtained just before, during, and 24 hours after operation.

All the population characteristics and intraoperative variables were similar in the two groups. Hematologic data after CPB and protamine administration revealed a significantly (p < .05) longer activated partial thromboplastin time in the 32°C group; however, the difference in blood loss did not reach significance. Our study shows that both perfusion temperatures equally well facilitated CPB for this type of intracardiac surgery.