Effect of Slow versus Rapid Rewarming on Jugular Bulb Oxygen Saturation in Adult Patients undergoing Open Heart Surgery

BACKGROUND:

A debate has
appeared in the recent literature about the optimum rewarming strategy
(slow vs. rapid) for the best brain function. This study was designed to
compare the effect of slow versus rapid rewarming on jugular bulb
oxygen saturation (SjO2) in adult patients undergoing open heart
surgery.

MATERIALS AND METHODS:

A total of 80 patients
undergoing valve and adult congenital heart surgery were randomly
allocated equally to rapid rewarming group 0.5 (0.136)°C/min and slow
rewarming group 0.219 (0.055)°C/min in jugular bulb sampling was taken
before, during and after surgery. Surgery was done at cardiopulmonary bypass (CPB) temperature of 28-30°C and rewarming was performed at the end of the surgical procedure.

RESULTS:

CPB
time, rewarming period were significantly longer in the slow rewarming
group. Significant difference was observed in the number of the
desaturated patients (SjO2 ≤ 50%) between the two groups; 14 (35%) in
rapid rewarming versus 6 (15%) in the slow rewarming group; P = 0.035 by
Fisher’s exact test.

CONCLUSIONS:

Slow rewarming could reduce the incidence of SjO2 desaturation during rewarming in adult patients undergoing open heart surgery.