Moderate Hypothermic Versus Normothermic Total Cardiopulmonary Bypass for Coronary Artery Surgery: A Retrospective Study

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Abstract
A retrospective analysis of 200 patients who underwent coronary artery bypass surgery between 1987 and 1990 was performed to ascertain whether there was any difference in morbidity or mortality with normothermic versus moderate hypothermic perfusion. Total cardiopulmonary bypass was used in all patients. 100 patients (Group H) were perfused using moderate (28-32°C) hypothermia and the remaining 100 patients (Group N) were perfused at normothermia (37°C). Both groups were comparable for age, weight, BSA, and perfusion time (Group Hmean 64 years, 82 Kg., 1.92 m2 , 94 minutes; Group Nmean 63 years, 82 Kg., 1.90 m2, 90 minutes). Mean perfusate temperature in Group H was 31°C, while the normothermic group was maintained at 37°c. Both groups were perfused to maintain a venous oxygen saturation between 65-70 percent and arterial pressure between 60-70 mmHg. The cardiac index during bypass for Group H was lower (2.32 ± .19 Ll m2 I min) than Group N (2.55 ± .11 Ll m2 I min) (p< 0.001). Mean arterial pressure for Group H was 69 ± 12.4 mmHg and for Group N was 63 ± 7.8 mmHg (p< 0.001). Oxygen transfer for Group N (159 ± 43 ccl min) was higher than Group H (113 + 31cclmin) (p< .001). Metabolic acidosis was not observed in either group. Group H required vasodilators while Group N required vasoconstriction to maintain pressures on total bypass between 60-70 mmHg. Six patients in Group H and 13 patients in Group N required blood transfusion during bypass to maintain a hematocrit above 20 percent.

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