C. Eich1, W. Zink1, S. K. W. Schwarz2, O. Radke1,3, A. Bräuer1
1Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Germany; 2Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver,B.C., Canada; 3Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
[Applied Cardiopulmonary Pathophysiology 13: 3-10, 2009]
Background: We conducted an audit to investigate the efficacy of a proposed standard operating procedure (SOP) on convective and conductive perioperative thermal management during paediatric cardiac anaesthesia.
Methods: We retrospectively studied 26 consecutive children who underwent cardiac surgery under cardiopulmonary bypass (CPB). We applied a heating mattress and a forced-air blanket during anaesthesia induction, before CPB, during the rewarming period, and after discontinuation of CPB. Core body temperatures were recorded continuously.
Results: All children (aged 1 day to 13.5 yr, median 25 months) were divided into three groups: < 5 kg (group I, n = 9), 5–15 kg (II, n = 8), and > 15 kg (III, n = 9). Mean (± SD) core body temperatures were as follows: at the start of surgery 35.8 ± 1.0°C (I), 35.9 ± 0.6°C (II), and 36.3 ± 0.3°C (III); at the start of bypass 35.9 ± 1.1°C (I), 36.4 ± 1.1°C (II), and 36.5 ± 0.7 °C (III). Temperatures after rewarming were 36.4 ± 0.4 °C (I), 36.2 ± 0.4 °C (II), and 36.0 ± 0.4°C (III). After weaning from bypass, core body temperatures were 36.7 ± 0.9°C (I), 37.3 ± 0.7°C (II), and 37.1 ± 0.7°C (III). Normothermia on admission to ICU was maintained in all but three small infants.
Conclusions: In children undergoing cardiac surgery, a combination of convective and conductive warming can effectively ensure perioperative normothermia before and after CPB.
Keywords: anaesthesia: paediatric cardiac; circulatory arrest: deep hypothermia induced; hypothermia: induced; warming: conductive; warming: convective
Address for corresponding: Christoph Eich, M.D., DEAA, Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany; firstname.lastname@example.org