Troponin I, and Lactic Acid variations, during Cardiopulmonary Bypass under Moderate Hypothermia vs Normothermia.

Abstract

Introduction: In open heart surgery such as Coronary artery Bypass Grafting, valve repair or replacement, or some congenital heart disease, patients are connected to the Cardiopulmonary bypass machine [1]. Cardiopulmonary bypass machine pumps the blood around the body while the heart is stopped and provides a bloodless field during cardiac surgery. Since an extracorporeal circuit is incorporated to the patient, there are observed abnormal physiological events during Cardiopulmonary bypass. These events include hemodilution, interstitial fluid accumulation, complement activation and depression of immune system. Cardiopulmonary bypass is associated with an acute phase reaction of protease cascades, leucocyte, and platelet activation that result in tissue injury [2, 3] and limited functional reserve. For many years was believed that Cardiopulmonary bypass under hypothermia is much safer.  The main reason for “cooling body” is to protect the brain, heart and organs during cardiopulmonary bypass through reducing body metabolic rate [4]. During more recent years, according to many studies, it is shown that Cardiopulmonary bypass under Normothermia has much more advantages compared to Moderate Hypothermia. The aim of this study was to compare and examine which method has advantages in terms of clinical outcome, morbidity and mortality. Patients and methods. 60 patients were selected, who were scheduled for Coronary artery Bypass Grafting x 3, were enrolled in this study. Results: According to the primary variables (Troponin I, Lactic Acid) and also secondary variables of our study, resulted that Cardiopulmonary bypass in Normothermia has superiority compare to Moderate Hypothermia in patients that underwent Coronary artery Bypass Grafting. Conclusion: According to our data and literature [15, 16, 17], we concluded that Cardiopulmonary bypass in Coronary artery Bypass Grafting under Normothermia has advantages vs Moderate Hypothermia and Troponin I and Lactic Acid are very good biomarkers that show us if heart and organs perfusion/protection is adequate during this procedure.