[Clinical advantages and myocardial protection of normothermal CPB--comparison with hypothermal CPB]

Abstract

We studied the clinical advantages and myocardial protection of normothermal CPB with comparing to hypothermal CPB. 22-cases of adult CABG were classified under two groups, according to the temperature of CPB. (Normothermal group: 37 degrees C, Hypothermal group: 32 degrees C) In both groups, the assistant CPB time after aortic declamp, the use of cardioversion that meaned the spontaneous recovery to sinus rhythm appeared or not, the dose of cathecholamines in- and post-operation, and the amounts of postoperative bleeding (after 6 h and 12 h) were compared as the clinical results and the data of CPK-MB, Myocin LC-II, and Troponin-T were measured as the effects of myocardial protection. The method of myocardial protection was the intermittent antegrade cold blood cardioplegia with terminal warm blood for all cases. As a result, the assistant CPB time after aortic declamp, the use of cardiovasion, and the amounts of postoperative bleeding (both of 6 h and 12 h) were less in normothermal group rather than in hypothermal group. (p < 0.05). However we had no differences about the dose of cathecholamines in post-operation and the data of three items between two groups. So, it suggests that the sufficient effects of myocardial protection could be obtained in normothermal CPB as in hypothermal CPB. Therefore we conclude that normothermal CPB could provide some clinical advantages, such as shortening CPB time, recovery of sinus rhythm, and prevention of postoperative bleeding, compared to hypothermal CPB and sufficient myocardial protection.