Document Detail


The neurologic sequelae of cardiopulmonary bypass-induced cerebral hyperthermia and cerebroprotective strategies.
MedLine Citation:
PMID:  14979423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cerebral hyperthermia during the rewarming phase of cardiopulmonary bypass (CPB) is associated with adverse outcomes. Cerebral hyperthermia can exacerbate a preexisting injury prior to rewarming, and may be damaging in itself. Temperature and cerebral metabolic rate (CMRO2) play a vital role in cerebral autoregulation. Therefore, hyperthermia can have a strong impact on cerebral oxygen transfer, and neurologic outcome. Glutamate levels can increase during cerebral hyperthermia, leading to eventual cell death. Rapid rewarming decreases jugular venous hemoglobin saturation, creating a mismatch between cerebral oxygen consumption and delivery. With these ill effects in mind, cerebral protection during CPB is imperative. Special attention should be given during rewarming to prevent these harmful outcomes. Pharmacologic agents such as sodium nitroprusside can be used to assist the rewarming process. Temperature management is the key component during the rewarming phase of CPB in the prevention of cerebral hyperthermia.
Authors:
Todd Scheffer; D Bradford Sanders
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of extra-corporeal technology     Volume:  35     ISSN:  0022-1058     ISO Abbreviation:  J Extra Corpor Technol     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-02-24     Completed Date:  2004-03-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0267637     Medline TA:  J Extra Corpor Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-21     Citation Subset:  T    
Affiliation:
Rush University, Department of Perfusion Technology, Rush Presbyterian St. Luke's Medical Center, Chicago, Illinois 60612, USA. tschef@earthlink.net
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MeSH Terms
Descriptor/Qualifier:
Body Temperature Regulation
Brain / physiopathology*
Cardiopulmonary Bypass / adverse effects*,  methods
Fever / etiology*,  metabolism,  physiopathology
Humans
Rewarming / adverse effects,  methods
Systemic Inflammatory Response Syndrome / etiology,  physiopathology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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