Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage
Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery. We assessed the efficacy of the Allon thermoregulation system (MTRE Advanced Technologies Ltd, Or-Akiva, Israel) compared with that of routine thermal care in maintaining normothermia du...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2005-06, Vol.129 (6), p.1371-1378 |
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| creator | Nesher, Nahum Uretzky, Gideon Insler, Steven Nataf, Patrick Frolkis, Inna Pineau, Emmanuelle Cantoni, Emmanuel Bolotin, Gil Vardi, Moshe Pevni, Dimitry Lev-Ran, Oren Sharony, Ram Weinbroum, Avi A. |
| description | Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery. We assessed the efficacy of the Allon thermoregulation system (MTRE Advanced Technologies Ltd, Or-Akiva, Israel) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery.
Patients undergoing off-pump coronary artery bypass surgery were perioperatively and randomly warmed with the 2 techniques (n = 45 per group). Core temperature, hemodynamics, and troponin I, interleukin 6, interleukin 8, and interleukin 10 blood levels were assessed.
The mean temperature of the patients in the Allon thermoregulation system group (AT group) was significantly (
P < .005) higher than that of the patients receiving routine thermal care (the RTC group); less than 40% of the latter reached 36°C compared with 100% of the former. The cardiac index was higher and the systemic vascular resistance was lower (
P < .05) by 16% and 25%, respectively, in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours. End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly (
P < .01) lower in the patients in the AT group than in the RTC group. The RTC group’s troponin levels closely correlated with their interleukin 6 levels at the end of the operation (
R = 0.51,
P = .002).
Unlike routine thermal care, the Allon thermoregulation system maintains core normothermia in more than 80% of patients undergoing off-pump coronary artery bypass surgery. Normothermia is associated with better cardiac and vascular conditions, a lower cardiac injury rate, and a lower inflammatory response. The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient’s outcome. |
| doi_str_mv | 10.1016/j.jtcvs.2004.08.021 |
| format | Article |
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Patients undergoing off-pump coronary artery bypass surgery were perioperatively and randomly warmed with the 2 techniques (n = 45 per group). Core temperature, hemodynamics, and troponin I, interleukin 6, interleukin 8, and interleukin 10 blood levels were assessed.
The mean temperature of the patients in the Allon thermoregulation system group (AT group) was significantly (
P < .005) higher than that of the patients receiving routine thermal care (the RTC group); less than 40% of the latter reached 36°C compared with 100% of the former. The cardiac index was higher and the systemic vascular resistance was lower (
P < .05) by 16% and 25%, respectively, in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours. End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly (
P < .01) lower in the patients in the AT group than in the RTC group. The RTC group’s troponin levels closely correlated with their interleukin 6 levels at the end of the operation (
R = 0.51,
P = .002).
Unlike routine thermal care, the Allon thermoregulation system maintains core normothermia in more than 80% of patients undergoing off-pump coronary artery bypass surgery. Normothermia is associated with better cardiac and vascular conditions, a lower cardiac injury rate, and a lower inflammatory response. The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient’s outcome.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2004.08.021</identifier><identifier>PMID: 15942580</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Aged ; Biological and medical sciences ; Body Temperature ; Cardiology. Vascular system ; Coronary Artery Bypass, Off-Pump - adverse effects ; Coronary heart disease ; Female ; Heart ; Heart Diseases - etiology ; Heart Diseases - prevention & control ; Humans ; Hyperthermia, Induced - methods ; Hypothermia - etiology ; Hypothermia - prevention & control ; Male ; Medical sciences ; Postoperative Complications - etiology ; Postoperative Complications - immunology ; Postoperative Complications - prevention & control ; Prospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2005-06, Vol.129 (6), p.1371-1378</ispartof><rights>2005 The American Association for Thoracic Surgery</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-46036349f1655f38e4ca3dc016ba4143b71c3baa07c80a360c46c8dda5b01aae3</citedby><cites>FETCH-LOGICAL-c465t-46036349f1655f38e4ca3dc016ba4143b71c3baa07c80a360c46c8dda5b01aae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522304012310$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16960053$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15942580$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nesher, Nahum</creatorcontrib><creatorcontrib>Uretzky, Gideon</creatorcontrib><creatorcontrib>Insler, Steven</creatorcontrib><creatorcontrib>Nataf, Patrick</creatorcontrib><creatorcontrib>Frolkis, Inna</creatorcontrib><creatorcontrib>Pineau, Emmanuelle</creatorcontrib><creatorcontrib>Cantoni, Emmanuel</creatorcontrib><creatorcontrib>Bolotin, Gil</creatorcontrib><creatorcontrib>Vardi, Moshe</creatorcontrib><creatorcontrib>Pevni, Dimitry</creatorcontrib><creatorcontrib>Lev-Ran, Oren</creatorcontrib><creatorcontrib>Sharony, Ram</creatorcontrib><creatorcontrib>Weinbroum, Avi A.</creatorcontrib><title>Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery. We assessed the efficacy of the Allon thermoregulation system (MTRE Advanced Technologies Ltd, Or-Akiva, Israel) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery.
Patients undergoing off-pump coronary artery bypass surgery were perioperatively and randomly warmed with the 2 techniques (n = 45 per group). Core temperature, hemodynamics, and troponin I, interleukin 6, interleukin 8, and interleukin 10 blood levels were assessed.
The mean temperature of the patients in the Allon thermoregulation system group (AT group) was significantly (
P < .005) higher than that of the patients receiving routine thermal care (the RTC group); less than 40% of the latter reached 36°C compared with 100% of the former. The cardiac index was higher and the systemic vascular resistance was lower (
P < .05) by 16% and 25%, respectively, in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours. End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly (
P < .01) lower in the patients in the AT group than in the RTC group. The RTC group’s troponin levels closely correlated with their interleukin 6 levels at the end of the operation (
R = 0.51,
P = .002).
Unlike routine thermal care, the Allon thermoregulation system maintains core normothermia in more than 80% of patients undergoing off-pump coronary artery bypass surgery. Normothermia is associated with better cardiac and vascular conditions, a lower cardiac injury rate, and a lower inflammatory response. The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient’s outcome.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Body Temperature</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Artery Bypass, Off-Pump - adverse effects</subject><subject>Coronary heart disease</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Diseases - etiology</subject><subject>Heart Diseases - prevention & control</subject><subject>Humans</subject><subject>Hyperthermia, Induced - methods</subject><subject>Hypothermia - etiology</subject><subject>Hypothermia - prevention & control</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - immunology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcuO1DAQRSMEYpqBL0BC3oDYpLHjPBcsRiNe0khsBomdVXEqHbcSO7icbuUr-SXcD2l2rGpR595bqpskbwXfCi7KT_vtPugDbTPO8y2vtzwTz5KN4E2VlnXx-3my4TzL0iLL5E3yimjPOa-4aF4mN6Jo8qyo-Sb5-zign1x69DCzgHqwbnS7lc0eCf0BiVkX9-FEGWAthoCehQEs824JxiI772BkGjwyY9kMwaANxBbbod85Y3fM9X06L9PMtPPOgl8Z-Gi0snadgYiB7ZiJg8hpAwE7djRhYKM7xjQzTUvMiRfNzhKe4REp3sem1cXYzsT4DibY4evkRQ8j4ZvrvE1-ff3yeP89ffj57cf93UOq87IIaV5yWcq86UVZFL2sMdcgOx3f2kIuctlWQssWgFe65iBLHmW67jooWi4AUN4mHy6-s3d_FqSgJkMaxxEsuoVUWTVCClFEUF5A7R2Rx17N3kzxA0pwdepR7dW5R3XqUfFaxR6j6t3Vfmkn7J401-Ii8P4KAGkYew9WG3riyqbkvJCR-3jhBrMbjsajotjVGG3FKZZE1qhSCVmdMj9fUIx_Oxj0inQsUmMXZTqozpn_3vwPNuTR1A</recordid><startdate>20050601</startdate><enddate>20050601</enddate><creator>Nesher, Nahum</creator><creator>Uretzky, Gideon</creator><creator>Insler, Steven</creator><creator>Nataf, Patrick</creator><creator>Frolkis, Inna</creator><creator>Pineau, Emmanuelle</creator><creator>Cantoni, Emmanuel</creator><creator>Bolotin, Gil</creator><creator>Vardi, Moshe</creator><creator>Pevni, Dimitry</creator><creator>Lev-Ran, Oren</creator><creator>Sharony, Ram</creator><creator>Weinbroum, Avi A.</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050601</creationdate><title>Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage</title><author>Nesher, Nahum ; Uretzky, Gideon ; Insler, Steven ; Nataf, Patrick ; Frolkis, Inna ; Pineau, Emmanuelle ; Cantoni, Emmanuel ; Bolotin, Gil ; Vardi, Moshe ; Pevni, Dimitry ; Lev-Ran, Oren ; Sharony, Ram ; Weinbroum, Avi A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-46036349f1655f38e4ca3dc016ba4143b71c3baa07c80a360c46c8dda5b01aae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Body Temperature</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Artery Bypass, Off-Pump - adverse effects</topic><topic>Coronary heart disease</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Diseases - etiology</topic><topic>Heart Diseases - prevention & control</topic><topic>Humans</topic><topic>Hyperthermia, Induced - methods</topic><topic>Hypothermia - etiology</topic><topic>Hypothermia - prevention & control</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - immunology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nesher, Nahum</creatorcontrib><creatorcontrib>Uretzky, Gideon</creatorcontrib><creatorcontrib>Insler, Steven</creatorcontrib><creatorcontrib>Nataf, Patrick</creatorcontrib><creatorcontrib>Frolkis, Inna</creatorcontrib><creatorcontrib>Pineau, Emmanuelle</creatorcontrib><creatorcontrib>Cantoni, Emmanuel</creatorcontrib><creatorcontrib>Bolotin, Gil</creatorcontrib><creatorcontrib>Vardi, Moshe</creatorcontrib><creatorcontrib>Pevni, Dimitry</creatorcontrib><creatorcontrib>Lev-Ran, Oren</creatorcontrib><creatorcontrib>Sharony, Ram</creatorcontrib><creatorcontrib>Weinbroum, Avi A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nesher, Nahum</au><au>Uretzky, Gideon</au><au>Insler, Steven</au><au>Nataf, Patrick</au><au>Frolkis, Inna</au><au>Pineau, Emmanuelle</au><au>Cantoni, Emmanuel</au><au>Bolotin, Gil</au><au>Vardi, Moshe</au><au>Pevni, Dimitry</au><au>Lev-Ran, Oren</au><au>Sharony, Ram</au><au>Weinbroum, Avi A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2005-06-01</date><risdate>2005</risdate><volume>129</volume><issue>6</issue><spage>1371</spage><epage>1378</epage><pages>1371-1378</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Perioperative hypothermia might be detrimental to the patient undergoing off-pump coronary artery bypass surgery. We assessed the efficacy of the Allon thermoregulation system (MTRE Advanced Technologies Ltd, Or-Akiva, Israel) compared with that of routine thermal care in maintaining normothermia during and after off-pump coronary artery bypass surgery.
Patients undergoing off-pump coronary artery bypass surgery were perioperatively and randomly warmed with the 2 techniques (n = 45 per group). Core temperature, hemodynamics, and troponin I, interleukin 6, interleukin 8, and interleukin 10 blood levels were assessed.
The mean temperature of the patients in the Allon thermoregulation system group (AT group) was significantly (
P < .005) higher than that of the patients receiving routine thermal care (the RTC group); less than 40% of the latter reached 36°C compared with 100% of the former. The cardiac index was higher and the systemic vascular resistance was lower (
P < .05) by 16% and 25%, respectively, in the individuals in the AT group compared with in the individuals in the RTC group during the 4 postoperative hours. End-of-surgery interleukin 6 levels and 24-hour postoperative troponin I levels were significantly (
P < .01) lower in the patients in the AT group than in the RTC group. The RTC group’s troponin levels closely correlated with their interleukin 6 levels at the end of the operation (
R = 0.51,
P = .002).
Unlike routine thermal care, the Allon thermoregulation system maintains core normothermia in more than 80% of patients undergoing off-pump coronary artery bypass surgery. Normothermia is associated with better cardiac and vascular conditions, a lower cardiac injury rate, and a lower inflammatory response. The close correlation between the increased interleukin 6 and troponin I levels in the routine thermal care group indicates a potential deleterious effect of lowered temperature on the patient’s outcome.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>15942580</pmid><doi>10.1016/j.jtcvs.2004.08.021</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of thoracic and cardiovascular surgery, 2005-06, Vol.129 (6), p.1371-1378 |
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| source | MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Biological and medical sciences Body Temperature Cardiology. Vascular system Coronary Artery Bypass, Off-Pump - adverse effects Coronary heart disease Female Heart Heart Diseases - etiology Heart Diseases - prevention & control Humans Hyperthermia, Induced - methods Hypothermia - etiology Hypothermia - prevention & control Male Medical sciences Postoperative Complications - etiology Postoperative Complications - immunology Postoperative Complications - prevention & control Prospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Thermo-wrap technology preserves normothermia better than routine thermal care in patients undergoing off-pump coronary artery bypass and is associated with lower immune response and lesser myocardial damage |
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