Title : Effects of Cardiopulmonary Bypass Temperature in Adult Cardiac surgery: A Single-Centre Parallel-group Open Randomised Controlled Trial
Background and Aim:
Cardiopulmonary bypass is an integral and essential part of cardiac surgery. Over the years, there has been an increasing debate over the cardiopulmonary temperatures and its effects on post-operative patient outcome. While some studies have shown beneficial effects of hypothermic cardiopulmonary bypass while others have shown that normothermia is the way to go. Hence further studies are necessary to assess the effects of cardiopulmonary bypass temperatures on patient outcomes. The aim of our study was to assess the merits and demerits in terms of patient outcomes of normothermic CPB over hypothermic CPB during open heart surgeries in adult patients.
A total of 100 adult patients undergoing Coronary artery bypass grafting or other forms of open heart surgery at Post Graduate Institute of Medical Education and Research, Chandigarh, India between January 2016 and April 2017 were randomised into 2 groups of 50 each. While one arm was operated using normothermic CPB, the other was operated on hypothermic CPB. Post –operative outcomes were compared between the two groups. Statistical analysis was done using SPSS software. The co-primary end points were inotropic and ventilatory requirements along with post-operative hospital stay. Several secondary including transfusion requirements, cardiac arrhythmias, post-operative bleeding and ventricular function were also assessed.
Normothermic CPB resulted in reduced post-operative ICU and hospital stay, less requirements of post-operative mechanical ventilation, fewer derangements in coagulation profile and post-operative drain output, less transfusion requirements in comparison to the patients who were operated using hypothermic CPB. However there was no significant difference in renal function, mean blood sugar levels, postoperative fever, wound infection, arrhythmia and need for re-exploration among the two groups.
From the results of our study, we recommend that normothermic cardiopulmonary bypass is associated with better post-operative outcomes although adequate myocardial protection is always necessary.