Anesthetic Management of a Patient with Cryoglobulinemia for Open-Heart Surgery under Normothermic Cardiopulmonary Bypass

We anesthetized a 70-year-old patient with cryoglobulinemia for open-heart surgery under normothermic cardiopulmonary bypass (CPB), using various anesthetic agents. Patients undergoing normothermic CPB have predictably higher cerebral oxygen demand and may be at higher risk for ischemic brain injury than those undergoing hypothermic CPB. Balanced anesthesia with inhaled and intravenous anesthetic agents without administration of vasodilators provided excellent hemodynamics and keep anesthetic level as deep as possible during normothermic CPB in this patient. Since anesthetic requirements during normothermic CPB have not been clarified, further studies are required.