Rewarming a Hypothermic Patient

Mechanism of Injury

• Cerebral Hyperthermia (>37 degrees C) following rewaming during cardiopulmonary bypass and early post-CPB period may increase cerebral metabolic rate increasing risk for cerebral desaturation([FOOTNOTE=Kawahara F, Kadoi Y, Saito S, Goto F, Fujita N. Slow rewarming improves jugular venous oxygen saturation during rewarming. Acta anaesthesiologica Scandinavica. 2003;47(4):419-424.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=883109])
• Evidence suggests that hyperthermia also impairs cerebral autoregulation, potentially exacerbating the potential for neurological injury([FOOTNOTE=Joshi B, Brady K, Lee J, et al. Impaired autoregulation of cerebral blood flow during rewarming from hypothermic cardiopulmonary bypass and its potential association with stroke. Anesthesia and analgesia. 2010;110(2):321-328.],[ANCHOR=],[LINK=])

Associated Outcome

• Uncontrolled hyperthermia following rewarming during cardiopulmonary bypass and early post-CPB period may lead to worse neurocognitive outcomes([FOOTNOTE=Grigore AM, Murray CF, Ramakrishna H, Djaiani G. A core review of temperature regimens and neuroprotection during cardiopulmonary bypass: does rewarming rate matter? Anesthesia and analgesia. 2009;109(6):1741-1751.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=883101])