Continuous jugular venous versus nasopharyngeal temperature monitoring during hypothermic cardiopulmonary bypass for cardiac surgery

Hilary P. Grocott, Mark F. Newman, Narda D. Croughwell, William D. White, Edward Lowry, Joseph G. Reves

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Study Objective: To compare jugular venous to nasopharyngeal temperature during hypothermic cardiopulmonary bypass (CPB). Design: Prospective observational study. Setting: Tertiary care teaching hospital. Patients: 5 ASA physical status IV patients (40 to 65 years of age) having cardiac surgery with hypothermic CPB. Interventions, Measurements and Main Results: Jugular venous and nasopharyngeal temperatures were recorded throughout the procedure with comparisons made during four time periods: pre-CPB during CPB, during rewarming, and post-CPB. The patients underwent 85.8 ± 45.8 minutes (mean ± SD) of hypothermic CPB cooling to 26.3 ± 7.6°C (nasopharyngeal) followed by rewarming at 0. 35 ± 0.l°C (nasopharyngeal)/min. There was a high degree of precision between the two temperature sites, but marked differences in bias. In particular, temperature bias was more pronounced during rewarming from CPB compared with other time periods (p < 0. 05) where jugular venous temperature was greater than nasopharyngeal temperature by 3.4°C. Conclusions: Nasopharyngeal temperature underestimates jugular venous temperature during rewarming from hypothermic CPB. As a result, the brain may be exposed to periods of hyperthermia possibly increasing the risk of neurologic injury associated with CPB.

Original languageEnglish
Pages (from-to)312-316
Number of pages5
JournalJournal of Clinical Anesthesia
Volume9
Issue number4
DOIs
StatePublished - Jun 1997

Bibliographical note

Funding Information:
Supported in part by grants from the National Institutes of Health (ROl-AG09663); the Anesthesia Patient Safety Foundation, Boston, MA, and the American Heart Association (95010970), Durham, NC.

Keywords

  • Cardiac surgery
  • Cardiopulmonary bypass
  • Hypothermic Temperature
  • Jugular venous
  • Nasopharyngeal

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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