Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage

Nahum Nesher, Gideon Uretzky, Steven Insler, Patrick Nataf, Inna Frolkis, Emmanuelle Pineau, Emmanuel Cantoni, Gil Bolotin, Moshe Vardi, Dimitry Pevni, Oren Lev-Ran, Ram Sharony, Avi A. Weinbroum*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery. We assessed the efficacy of the Allon thermoregulation system (MTRE Advanced Technologies Ltd, Or-Akiva, Israel) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery. Methods: Patients undergoing off-pump coronary artery bypass surgery were perioperatively and randomly warmed with the 2 techniques (n = 45 per group). Core temperature, hemodynamics, and troponin I, interleukin 6, interleukin 8, and interleukin 10 blood levels were assessed. Results: The mean temperature of the patients in the Allon thermoregulation system group (AT group) was significantly (P <. 005) higher than that of the patients receiving routine thermal care (the RTC group); less than 40% of the latter reached 36°C compared with 100% of the former. The cardiac index was higher and the systemic vascular resistance was lower (P <. 05) by 16% and 25%, respectively, in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours. End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly (P <. 01) lower in the patients in the AT group than in the RTC group. The RTC group's troponin levels closely correlated with their interleukin 6 levels at the end of the operation (R = 0.51, P =. 002). Conclusions: Unlike routine thermal care, the Allon thermoregulation system maintains core normothermia in more than 80% of patients undergoing off-pump coronary artery bypass surgery. Normothermia is associated with better cardiac and vascular conditions, a lower cardiac injury rate, and a lower inflammatory response. The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient's outcome.

Original languageEnglish
Pages (from-to)1371-1378
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume129
Issue number6
DOIs
StatePublished - Jun 2005

Funding

FundersFunder number
MTRE Advanced Technologies Ltd

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