Hypothermia During Cardiopulmonary Bypass Increases Need for Inotropic Support but Does Not Impact Inflammation in Children Undergoing Surgical Ventricular Septal Defect Closure. Schmitt, K. R. L., Fedarava, K., Justus, G., Redlin, M., Bottcher, W., Delmo Walter, E. M., Hetzer, R., Berger, F., & Miera, O. Artificial organs, 40(5):470--9, 2016. Schmitt, Katharina Rose Luise. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. Fedarava, Katsiaryna. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. Justus, Georgia. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. Redlin, Mathias. Department of Anesthesiology, Deutsches Herzzentrum Berlin, Berlin, Germany. Bottcher, Wolfgang. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. Delmo Walter, Eva Maria. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. Hetzer, Roland. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. Berger, Felix. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. Berger, Felix. Department of Pediatrics, Division of Cardiology, Charite-Universitatsmedizin, Berlin, Germany. Miera, Oliver. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
abstract   bibtex   
Minimizing the systemic inflammatory response caused by cardiopulmonary bypass is a major concern. It has been suggested that the perfusion temperature affects the inflammatory response. The aim of this prospective study was to compare the effects of moderate hypothermia (32degreeC) and normothermia (36degreeC) during cardiopulmonary bypass on markers of the inflammatory response and clinical outcomes (time on ventilator) after surgical closure of ventricular septal defects. During surgical closure of ventricular septal defects under cardiopulmonary bypass, 20 children (median age 4.9 months, range 2.3-38 months; median weight 7.2kg, range 5.2-11.7kg) were randomized to a perfusion temperature of either 32degreeC (Group 1, n=10) or 36degreeC (Group 2, n=10). The clinical data and blood samples were collected before cardiopulmonary bypass, directly after aortic cross-clamp release, and 4 and 24h after weaning from cardiopulmonary bypass. Time on ventilation as primary outcome did not differ between the two groups. Other clinical outcome parameters like fluid balance or length of stay in the intensive care were also similar in the two groups. Compared with Group 2, Group 1 needed significantly higher and longer inotropic support (P\textless0.001). In Group 1, two infants had junctional ectopic tachycardia, and another had a pulmonary hypertensive crisis. Perfusion temperature did not influence cytokine release, organ injury, or coagulation. Cardiopulmonary bypass temperature does not influence time on ventilation or inflammatory marker release. However, in the present study, with a small patient cohort, patients operated under hypothermic bypass needed higher and longer inotropic support. The use of hypothermic cardiopulmonary bypass in infants and children should be approached with care. , Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
@article{schmitt_hypothermia_2016,
	title = {Hypothermia {During} {Cardiopulmonary} {Bypass} {Increases} {Need} for {Inotropic} {Support} but {Does} {Not} {Impact} {Inflammation} in {Children} {Undergoing} {Surgical} {Ventricular} {Septal} {Defect} {Closure}.},
	volume = {40},
	issn = {1525-1594},
	abstract = {Minimizing the systemic inflammatory response caused by cardiopulmonary bypass is a major concern. It has been suggested that the perfusion temperature affects the inflammatory response. The aim of this prospective study was to compare the effects of moderate hypothermia (32degreeC) and normothermia (36degreeC) during cardiopulmonary bypass on markers of the inflammatory response and clinical outcomes (time on ventilator) after surgical closure of ventricular septal defects. During surgical closure of ventricular septal defects under cardiopulmonary bypass, 20 children (median age 4.9 months, range 2.3-38 months; median weight 7.2kg, range 5.2-11.7kg) were randomized to a perfusion temperature of either 32degreeC (Group 1, n=10) or 36degreeC (Group 2, n=10). The clinical data and blood samples were collected before cardiopulmonary bypass, directly after aortic cross-clamp release, and 4 and 24h after weaning from cardiopulmonary bypass. Time on ventilation as primary outcome did not differ between the two groups. Other clinical outcome parameters like fluid balance or length of stay in the intensive care were also similar in the two groups. Compared with Group 2, Group 1 needed significantly higher and longer inotropic support (P{\textless}0.001). In Group 1, two infants had junctional ectopic tachycardia, and another had a pulmonary hypertensive crisis. Perfusion temperature did not influence cytokine release, organ injury, or coagulation. Cardiopulmonary bypass temperature does not influence time on ventilation or inflammatory marker release. However, in the present study, with a small patient cohort, patients operated under hypothermic bypass needed higher and longer inotropic support. The use of hypothermic cardiopulmonary bypass in infants and children should be approached with care. , Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.},
	number = {5},
	journal = {Artificial organs},
	author = {Schmitt, Katharina Rose Luise and Fedarava, Katsiaryna and Justus, Georgia and Redlin, Mathias and Bottcher, Wolfgang and Delmo Walter, Eva Maria and Hetzer, Roland and Berger, Felix and Miera, Oliver},
	year = {2016},
	note = {Schmitt, Katharina Rose Luise. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Fedarava, Katsiaryna. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Justus, Georgia. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Redlin, Mathias. Department of Anesthesiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Bottcher, Wolfgang. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
Delmo Walter, Eva Maria. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
Hetzer, Roland. Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany.
Berger, Felix. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Berger, Felix. Department of Pediatrics, Division of Cardiology, Charite-Universitatsmedizin, Berlin, Germany.
Miera, Oliver. Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.},
	keywords = {*Cardiopulmonary Bypass/mt [Methods], *Heart Septal Defects, Ventricular/su [Surgery], *Hypothermia, Induced/mt [Methods], Blood Coagulation, Cytokines/bl [Blood], Heart Septal Defects, Ventricular/bl [Blood], Heart Septal Defects, Ventricular/co [Complications], Humans, Inflammation/bl [Blood], Inflammation/co [Complications], Prospective Studies, Systemic Inflammatory Response Syndrome/bl [Blood], Systemic Inflammatory Response Syndrome/co [Complications], female, infant, male, treatment outcome},
	pages = {470--9}
}

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