Normothermal or Hypothermal Extracorporeal Circulation Regimens in Patients with Acquired Heart Disease

• Main Authors: V. V. Lomivorotov, V. A. Shmyrev, S. M. Efremov, D. N. Ponomarev, G. B, Moroz, D. G. Shakhin, I. A. Kornilov, A. N. Shilova, V. N. Lomivorotov, S. I. Zheleznev
• Format: Article
• Language: Russian
• Published: Russian Academy of Medical Sciences 2013-08-01
• Series: Obŝaâ Reanimatologiâ
• Online Access: https://www.reanimatology.com/rmt/article/view/123
• ISSN: 1813-9779; 2411-7110

Background. Hypothermal extracorporeal circulation has been used in cardiosurgery over 50 years. However, recent trials have not shown its predominant effect on the protection of the brain, lung, and myocardium in patients during surgery. We have presumed that when normothermal extracorporeal circulation used in patients with acquired heart disease, its pathophysiological effect on the body is comparable with that of hypothermal extracorporeal circulation. Subjects and methods. One hundred and forty patients who were to undergo acquired heart disease correction were randomized into two equal groups: that using hypothermal or normothermal extracorporeal circulation. Perioperative troponin I and NT-proBNP concentrations, postoperative clinical course, and hospital morbidity and mortality rates were estimated. Results. There were no significant differences in the concentrations of troponin I and NT-proBNP at the study stages. In the normothermal extracorporeal circulation group patients with isolated aortic stenosis, the concentration of troponin I was higher than that in the hypothermal extracorporeal circulation group. Analyzing the postoperative course indicated that the duration of mechanical ventilation was significantly lower in the hypothermal extracorporeal circulation group than in the normothermal extracorporeal circulation group. There were no differences in hospital complications and mortality rates. Conclusion. Hypothermal versus normothermal extracorporeal circulation in the correction of acquired heart diseases has no predominant effect on tro-ponin I and NT-proBNP concentrations, postoperative clinical course, and hospital complications and mortality rates. Key words: extracorporeal circulation, hypothermia, acquired heart disease, troponin I, NT-proBNP.