A comprehensive literature review on hypothermia and early extubation following coronary artery bypass surgery

The purpose of this study was to comprehensively review the literature addressing the physiological effects of hypothermia and its association with the appropriate core body temperature for extubation following coronary artery bypass surgery. The electronic databases MEDLINE, CINAHL and Web of Science via OVID were used to identify studies for the literature review. Search words used included ‘core temperature’, ‘arrhythmia’, ‘cardiac’, ‘cardiac surgery’, ‘hypothermia’, ‘extubation’, ‘temperature’, ‘rewarming’, and ‘shivering’. The literature search yielded 55 articles that met our inclusion criteria. No studies specifically identified the benefit of extubation at 36.5° C. Although temperatures varied, arrhythmias resulting from hypothermia were not reported until core body temperature dropped below 33° C. This comprehensive literature review suggests extubation at lower temperatures (between 34° C and 36° C) may be viable if shivering and other factors known to contribute to myocardial stress can be controlled. These findings offer the possibility of earlier extubation which may promote beneficial health outcomes.