Influence of normothermic systemic perfusion during coronary artery bypass operations: A randomized prospective study

Abstract Objectives: Normothermic cardiopulmonary bypass has been proposed as a more physiologic technique than hypothermic bypass for the maintenance of the body during cardiac surgery. The aims of this study were to investigate the effects of systemic perfusion temperature on clinical outcome after coronary revascularization. Methods: Three hundred patients (mean age 60 ± 9 years, 88% male) were prospectively randomized into three groups: hypothermia (28° C, n = 100), moderate hypothermia (32° C, n = 100), and normothermia (37° C, n = 100). All patients received cold antegrade St. Thomas' Hospital crystalloid cardioplegic solution, and patients in the normothermic group were actively rewarmed during cardiopulmonary bypass (nasopharyngeal temperature 37° C). Results: No differences were found between groups with respect to mortality (1%), intraaortic balloon pump use, perioperative infarctionrates, focal neurologic deficits (1%), intubation time, intensive care unit stay, and postoperative hospital stay. Further stepwise regression analysis identified age and intensive care unit stay as important predictors of the variability in postoperative stay (both R 2 = 0.114, p p p p p p p p Conclusions: Cardiopulmonary bypass temperature did not influence early clinical outcome after routine coronary artery bypass operations. Normothermic systemic perfusion was associated with an increased requirement for vasoconstrictors and reduced requirements for electrical defibrillation and transfusion of blood products. (J Thorac Cardiovasc Surg 1997;114:475-81)