Postoperative rewarming and arterial pCO2 levels in patients extubated 4 versus 10 hours after uncomplicated coronary artery surgery
Piotr Knapik, James B. Richardson, Ian McLellan
Med Sci Monit 1999; 5(2): CR296-300
Background: Increasing popularity of coronary artery surgery has led to a reappraisal of the need for prolonged postoperative respiratory support after uncomplicated hypothermic cardiopulmonary bypass. Our clinical observations suggests that early extubation after open heart surgery decreased the core-peripheral temperature gradient and therefore shortened the rewarming period.
Material/Methods: We studied postoperatively and retrospectively 50 patients who underwent uncomplicated coronary artery bypass surgery, fulfilled strict entry criteria and were extubated 4 hours (group I, n=25) or 10 hours (group II, n=25) after termination of cardiopulmonary bypass.
Results: The differences between the core and the peripheral temperatures were not significant between groups up to the fifth postoperative hour and then became significant with group I rewarming quicker then group II. We also found, that early extubated patients retained higher CO2 levels than patients who were intubated and ventilated and this may partially explain quicker rewarming in group I.
Conclusions: Earlier extubated patients with higher initial core temperature are warming up significantly faster after uncomplicated coronary artery surgery and retain higher pCO2 levels.
Keywords: Body Temperature, cardiac surgery, artificial ventilation