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The Effect of Hypothermic and Normothermic Cardiopulmonary Bypass on Metabolic and Haemodynamic Parameters

Yıl 2025, Cilt: 8 Sayı: 4, 417 - 423, 31.12.2025
https://doi.org/10.36516/jocass.1793221
https://izlik.org/JA94RD42BF

Öz

Aim: The aim of this study is to investigate the changes in metabolic and haemodynamic parameters over time in patients undergoing coronary artery bypass grafting with hypothermic and normothermic cardiopulmonary bypass.

Methods: A total of 126 patients were included in the study: 64 patients who underwent normothermic (35–37 °C) CPB and 62 patients who underwent hypothermic (28–34 °C) CPB. Statistical analyses were performed using SPSS 25.0 and Python software, with p<0.05 accepted as the level of significance.

Results: During CPB, a decrease in albumin levels and an increase in AST, ALT, CRP, glucose, lactate, sodium, and total bilirubin levels were observed (p<0.05). However, no significant differences were found between the normothermic and hypothermic groups for most parameters (p>0.05).

Conclusion: In our study, although time-dependent significant changes were observed in the metabolic and haemodynamic parameters examined in hypothermic and normothermic cases, these changes were not found to constitute a statistically significant difference between the two groups.

Etik Beyan

It was approved by the decision numbered 12 dated 30.06.2025 of the Clinical Research Ethics Committee of Harran University Faculty of Medicine. This study was conducted in accordance with the Declaration of Helsinki, as revised in 1989.

Destekleyen Kurum

Harran Unıversity

Teşekkür

We believe our study will be beneficial to healthcare professionals working in the fields of cardiovascular surgery and perioperative care and will contribute to the scientific content of your journal. We present our article for your consideration and wish you continued success.

Kaynakça

  • 1.Ralapanawa U, & Sivakanesan, R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. Journal of Epidemiology and Global Health, 2021;11:169 - 177. [Crossref]
  • 2.Hendriks KDW, Castela Forte JN, Kok WF, Mungroop HE, Bouma HR, Scheeren TWL, et al. Mild hypothermia during cardiopulmonary bypass assisted CABG is associated with improved short- and long-term survival, a 18-year cohort study. PLoS One. 2022; 25;17(8):e0273370. [Crossref]
  • 3.Stern M, Kok WF, Doorduin J, Jongman RM, Jainandunsing J, Nieuwenhuijs-Moeke GJ, et al. Mild and deep hypothermia differentially affect cerebral neuroinflammatory and cold shock response following cardiopulmonary bypass in rat. Brain Behav Immun. 2024;119:96-104. [Crossref]
  • 4.Amer GF, Elawady MS, ElDerie A, Sanad M. Normothermia versus Hypothermia during Cardiopulmonary Bypass in Cases of Repair of Atrioventricular Septal Defect. Anesth Essays Res. 2020;14(1):112-118. [Crossref]
  • 5.Bianco V, Kilic A, Aranda-Michel E, Dunn-Lewis C, Serna-Gallegos D, Chen S, et al. Mild hypothermia versus normothermia in patients undergoing cardiac surgery. JTCVS Open. 2021 (17);7:230-242. [Crossref]
  • 6.Helman SM, Sereika S, Hravnak M, Henker R, Gaynor JW, Herrup E, et al. Association Between Persistent Hypothermia After Cardiopulmonary Bypass in Neonates and Odds of Serious Complications. Crit Care Explor. 2024;20;6(8):e1137. [Crossref]
  • 7.Keizman E, Mishaly D, Ram E, Urtaev S, Tejman-Yarden S, Tirosh Wagner T, et al. Normothermic Versus Hypothermic Norwood Procedure. World J Pediatr Congenit Heart Surg. 2023;14(2):125-132. [Crossref]
  • 8.Dankiewicz J, Cronberg T, Lilja G, Jakobsen JC, Levin H, Ullén S, et al. TTM2 Trial Investigators. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2021;17;384(24):2283-2294.
  • 9.Enayet K, Hussain M, Islam M, Karim T, Jahan T, Das P, et al. Serum Albumin and Its Influence on Immediate Outcomes in Children with Congenital Heart Disease Undergoing Cardiac Surgery. Bangladesh Heart Journal. 2024;75794. [Crossref]
  • 10.Karki S, Gajjar R, Bittar-Carlini G, Jha V, Yadav N. Association of Hypoalbuminemia With Clinical Outcomes in Patients Admitted With Acute Heart Failure. Curr Probl Cardiol. 2023;48(11):101916. [Crossref]
  • 11.Martin KR, Gamell C, Tai TY, Bonelli R, Hansen J, Tatoulis J, et al. Whole blood transcriptomics reveals granulocyte colony-stimulating factor as a mediator of cardiopulmonary bypass-induced systemic inflammatory response syndrome. Clin Transl Immunology. 2024;19;13(2):e1490. [Crossref]
  • 12.Reddy D, Sunitha Y, Thangavel D, Ramkumar J & Miller, S. Effects of cardiopulmonary bypass on liver function in patients undergoing cardiac surgery. CARDIOMETRY. [Crossref]
  • 13.Kumar R, Bansal M, Nath SS, Kumar V, Malviya D, Srivastava D. N-Acetylcysteine Supplementation for the Prevention of Postoperative Liver Dysfunction after On-Pump Cardiac Surgery. Turk J Anaesthesiol Reanim. 2021;49(6):460-469. [Crossref]
  • 14.Zakkar M, Amirak E & Bryan AJ. The effects of cardiopulmonary bypass on the liver: a review. Eur J Cardiothorac Surg, 2014;45(4): 661-667.
  • 15.Sabzi F, Faraji R. Liver Function Tests Following Open Cardiac Surgery. J Cardiovasc Thorac Res. 2015;7(2):49-54. [Crossref]
  • 16.Deininger S, Hoenicka M, Müller-Eising K, Rupp P, Liebold A, Koenig W, et al. Renal Function and Urinary Biomarkers in Cardiac Bypass Surgery: A Prospective Randomized Trial Comparing Three Surgical Techniques. Thorac Cardiovasc Surg. 2016;64(7):561-568. [Crossref]
  • 17.Leong XF, Cheng M, Jong B, Hwang NC, Roscoe A. Sodium Abnormalities in Cardiac Surgery With Cardiopulmonary Bypass in Adults: A Narrative Review. J Cardiothorac Vasc Anesth. 2021;35(11):3374-3384. [Crossref]
  • 18.He Y, Liu S, Luo Y, Wu H, Yu Y & Chen, H. Elevation of C-reactive protein early after cardiopulmonary bypass surgery is associated with occurrence of postoperative atrial fibrillation. Nan fang yi ke da xue xue bao = Journal of Southern Medical University, 2022;42 (3): 443-447.
  • 19.Milam AJ, Liang C, Mi J, Mascha EJ, Halvorson S, Yan M, et al. Derivation and Validation of Clinical Phenotypes of the Cardiopulmonary Bypass-Induced Inflammatory Response. Anesth Analg. 2023;1;136(3):507-517. [Crossref]
  • 20.Li S, Nordick KV, Murrieta-Álvarez I, Kirby RP, Bhattacharya R, Garcia I, et al. Prolonged Cardiopulmonary Bypass Time-Induced Endothelial Dysfunction via Glypican-1 Shedding, Inflammation, and Matrix Metalloproteinase 9 in Patients Undergoing Cardiac Surgery. Biomedicines. 2024;27;13(1):33. [Crossref]
  • 21.Ghasemzade B, Ghodrati M, Kachuian N, Banakar Y, Gorjipour F, Zarei A, & Zaree, H. Fibrinogen and Fibrin Degradation Products' Levels in Cardiopulmonary Bypass with Mild-Hypothermia versus Normothermia. 2020;V5I3.30324.
  • 22.Linassi F, Maran E, De Laurenzis A, Tellaroli P, Kreuzer M, Schneider G, et al. Targeted temperature management in cardiac surgery: a systematic review and meta-analysis on postoperative cognitive outcomes. Br J Anaesth. 2022;128(1):11-25. [Crossref]

Hipotermik ve Normotermik Kardiyopulmoner Bypassın Metabolik ve Hemodinamik Parametreler Üzerine Etkisi

Yıl 2025, Cilt: 8 Sayı: 4, 417 - 423, 31.12.2025
https://doi.org/10.36516/jocass.1793221
https://izlik.org/JA94RD42BF

Öz

Amaç: Bu çalışmanın amacı, hipotermik ve normotermik kardiyopulmoner bypass uygulanan koroner arter bypass greftleme hastalarında metabolik ve hemodinamik parametrelerin zaman içerisindeki değişimini incelemektir.

Materyal ve Metot: Çalışmaya, normotermik (35–37 °C) KPB uygulanan 64 ve hipotermik (28–34 °C) KPB uygulanan 62 olmak üzere toplam 126 hasta dahil edilmiştir. İstatistiksel analizlerde SPSS 25.0 ve Python yazılımı kullanılmış, p<0.05 anlamlılık düzeyi olarak kabul edilmiştir.

Bulgular: KPB süresince albümin düzeylerinde düşüş, AST, ALT, CRP, glukoz, laktat, sodyum ve total bilirubin düzeylerinde artış gözlenmiştir (p<0.05). Ancak normotermik ve hipotermik gruplar arasında çoğu parametrede anlamlı fark bulunmamıştır (p>0.05).

Sonuç: Çalışmamızda hipotermik ve normotermik olgularda incelenen metabolik ve hemodinamik parametrelerde zamana bağlı belirgin değişimler görülmekle birlikte, bu değişimlerin iki grup arasında istatistiksel olarak anlamlı bir fark oluşturmadığı saptanmıştır.

Etik Beyan

Harran Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu'nun 30.06.2025 tarih ve 12 sayılı kararıyla onaylanmıştır. Bu çalışma, 1989 yılında revize edilen Helsinki Bildirgesi'ne uygun olarak yürütülmüştür.

Destekleyen Kurum

Harran Üniversitesi

Teşekkür

Çalışmamızın, kardiyovasküler cerrahi ve perioperatif bakım alanlarında çalışan sağlık profesyonelleri için faydalı olacağını ve derginizin bilimsel içeriğine katkı sağlayacağını düşünmekteyiz. Değerli hakemlerinizin değerlendirmelerine sunulmak üzere makalemizi takdirlerinize arz eder, iyi çalışmalar dilerim.

Kaynakça

  • 1.Ralapanawa U, & Sivakanesan, R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. Journal of Epidemiology and Global Health, 2021;11:169 - 177. [Crossref]
  • 2.Hendriks KDW, Castela Forte JN, Kok WF, Mungroop HE, Bouma HR, Scheeren TWL, et al. Mild hypothermia during cardiopulmonary bypass assisted CABG is associated with improved short- and long-term survival, a 18-year cohort study. PLoS One. 2022; 25;17(8):e0273370. [Crossref]
  • 3.Stern M, Kok WF, Doorduin J, Jongman RM, Jainandunsing J, Nieuwenhuijs-Moeke GJ, et al. Mild and deep hypothermia differentially affect cerebral neuroinflammatory and cold shock response following cardiopulmonary bypass in rat. Brain Behav Immun. 2024;119:96-104. [Crossref]
  • 4.Amer GF, Elawady MS, ElDerie A, Sanad M. Normothermia versus Hypothermia during Cardiopulmonary Bypass in Cases of Repair of Atrioventricular Septal Defect. Anesth Essays Res. 2020;14(1):112-118. [Crossref]
  • 5.Bianco V, Kilic A, Aranda-Michel E, Dunn-Lewis C, Serna-Gallegos D, Chen S, et al. Mild hypothermia versus normothermia in patients undergoing cardiac surgery. JTCVS Open. 2021 (17);7:230-242. [Crossref]
  • 6.Helman SM, Sereika S, Hravnak M, Henker R, Gaynor JW, Herrup E, et al. Association Between Persistent Hypothermia After Cardiopulmonary Bypass in Neonates and Odds of Serious Complications. Crit Care Explor. 2024;20;6(8):e1137. [Crossref]
  • 7.Keizman E, Mishaly D, Ram E, Urtaev S, Tejman-Yarden S, Tirosh Wagner T, et al. Normothermic Versus Hypothermic Norwood Procedure. World J Pediatr Congenit Heart Surg. 2023;14(2):125-132. [Crossref]
  • 8.Dankiewicz J, Cronberg T, Lilja G, Jakobsen JC, Levin H, Ullén S, et al. TTM2 Trial Investigators. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2021;17;384(24):2283-2294.
  • 9.Enayet K, Hussain M, Islam M, Karim T, Jahan T, Das P, et al. Serum Albumin and Its Influence on Immediate Outcomes in Children with Congenital Heart Disease Undergoing Cardiac Surgery. Bangladesh Heart Journal. 2024;75794. [Crossref]
  • 10.Karki S, Gajjar R, Bittar-Carlini G, Jha V, Yadav N. Association of Hypoalbuminemia With Clinical Outcomes in Patients Admitted With Acute Heart Failure. Curr Probl Cardiol. 2023;48(11):101916. [Crossref]
  • 11.Martin KR, Gamell C, Tai TY, Bonelli R, Hansen J, Tatoulis J, et al. Whole blood transcriptomics reveals granulocyte colony-stimulating factor as a mediator of cardiopulmonary bypass-induced systemic inflammatory response syndrome. Clin Transl Immunology. 2024;19;13(2):e1490. [Crossref]
  • 12.Reddy D, Sunitha Y, Thangavel D, Ramkumar J & Miller, S. Effects of cardiopulmonary bypass on liver function in patients undergoing cardiac surgery. CARDIOMETRY. [Crossref]
  • 13.Kumar R, Bansal M, Nath SS, Kumar V, Malviya D, Srivastava D. N-Acetylcysteine Supplementation for the Prevention of Postoperative Liver Dysfunction after On-Pump Cardiac Surgery. Turk J Anaesthesiol Reanim. 2021;49(6):460-469. [Crossref]
  • 14.Zakkar M, Amirak E & Bryan AJ. The effects of cardiopulmonary bypass on the liver: a review. Eur J Cardiothorac Surg, 2014;45(4): 661-667.
  • 15.Sabzi F, Faraji R. Liver Function Tests Following Open Cardiac Surgery. J Cardiovasc Thorac Res. 2015;7(2):49-54. [Crossref]
  • 16.Deininger S, Hoenicka M, Müller-Eising K, Rupp P, Liebold A, Koenig W, et al. Renal Function and Urinary Biomarkers in Cardiac Bypass Surgery: A Prospective Randomized Trial Comparing Three Surgical Techniques. Thorac Cardiovasc Surg. 2016;64(7):561-568. [Crossref]
  • 17.Leong XF, Cheng M, Jong B, Hwang NC, Roscoe A. Sodium Abnormalities in Cardiac Surgery With Cardiopulmonary Bypass in Adults: A Narrative Review. J Cardiothorac Vasc Anesth. 2021;35(11):3374-3384. [Crossref]
  • 18.He Y, Liu S, Luo Y, Wu H, Yu Y & Chen, H. Elevation of C-reactive protein early after cardiopulmonary bypass surgery is associated with occurrence of postoperative atrial fibrillation. Nan fang yi ke da xue xue bao = Journal of Southern Medical University, 2022;42 (3): 443-447.
  • 19.Milam AJ, Liang C, Mi J, Mascha EJ, Halvorson S, Yan M, et al. Derivation and Validation of Clinical Phenotypes of the Cardiopulmonary Bypass-Induced Inflammatory Response. Anesth Analg. 2023;1;136(3):507-517. [Crossref]
  • 20.Li S, Nordick KV, Murrieta-Álvarez I, Kirby RP, Bhattacharya R, Garcia I, et al. Prolonged Cardiopulmonary Bypass Time-Induced Endothelial Dysfunction via Glypican-1 Shedding, Inflammation, and Matrix Metalloproteinase 9 in Patients Undergoing Cardiac Surgery. Biomedicines. 2024;27;13(1):33. [Crossref]
  • 21.Ghasemzade B, Ghodrati M, Kachuian N, Banakar Y, Gorjipour F, Zarei A, & Zaree, H. Fibrinogen and Fibrin Degradation Products' Levels in Cardiopulmonary Bypass with Mild-Hypothermia versus Normothermia. 2020;V5I3.30324.
  • 22.Linassi F, Maran E, De Laurenzis A, Tellaroli P, Kreuzer M, Schneider G, et al. Targeted temperature management in cardiac surgery: a systematic review and meta-analysis on postoperative cognitive outcomes. Br J Anaesth. 2022;128(1):11-25. [Crossref]
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kalp ve Damar Cerrahisi
Bölüm Araştırma Makalesi
Yazarlar

Mahmut Padak 0000-0001-6863-1907

Reşat Dikme 0000-0001-9157-7830

Gönderilme Tarihi 29 Eylül 2025
Kabul Tarihi 17 Aralık 2025
Yayımlanma Tarihi 31 Aralık 2025
DOI https://doi.org/10.36516/jocass.1793221
IZ https://izlik.org/JA94RD42BF
Yayımlandığı Sayı Yıl 2025 Cilt: 8 Sayı: 4

Kaynak Göster

APA Padak, M., & Dikme, R. (2025). The Effect of Hypothermic and Normothermic Cardiopulmonary Bypass on Metabolic and Haemodynamic Parameters. Journal of Cukurova Anesthesia and Surgical Sciences, 8(4), 417-423. https://doi.org/10.36516/jocass.1793221
https://dergipark.org.tr/tr/download/journal-file/11303