TY - JOUR
T1 - 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
AU - Nesher, Nahum
AU - Uretzky, Gideon
AU - Insler, Steven
AU - Nataf, Patrick
AU - Frolkis, Inna
AU - Pineau, Emmanuelle
AU - Cantoni, Emmanuel
AU - Bolotin, Gil
AU - Vardi, Moshe
AU - Pevni, Dimitry
AU - Lev-Ran, Oren
AU - Sharony, Ram
AU - Weinbroum, Avi A.
N1 - Funding Information:
This study was supported by a grant from MTRE Advanced Technologies Ltd, Or-Akiva Industrial Park, Israel.
PY - 2005/6
Y1 - 2005/6
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=20444384765&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2004.08.021
DO - 10.1016/j.jtcvs.2004.08.021
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C2 - 15942580
AN - SCOPUS:20444384765
SN - 0022-5223
VL - 129
SP - 1371
EP - 1378
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 6
ER -