Normothermic versus hypothermic cardiopulmonary bypass during repair of congenital heart disease

Objective: To compare normothermic cardiopulmonary bypass (CPB) versus hypothermic CPB in pediatric patients undergoing repair of congenital heart disease with focus on biochemical markers for brain damage. Design: Prospective randomized interventional study. Setting: Postgraduate teaching hospital. Participants: Twenty patients undergoing repair of congenital heart disease. Interventions: Patients were randomized to normothermic (36 degreesC) versus hypothermic (25 degreesC) CPB. Serum levels of neuron-specific enolase (NSE) and S-100 beta protein were measured in all patients before surgery, immediately after CPB, and 12 and 24 hours after surgery. Blood loss and time for extubation of the trachea were recorded. Measurements and Main Results: Before operation, the S-100 beta protein and NSE levels were similar in the 2 groups. The S-100 beta protein serum level increased significantly after CPB in both groups, whereas no change was found in the NSE level. There was no difference in the change of NSE and S-100 beta protein levels between normothermic and hypothermic CPB. Blood loss was significantly less after hypothermic CPB (25 mL/kg/24 h v 42 mL/kg/24 h). Time for extubation was similar. Conclusion: No difference was found in the release of brain-specific proteins between normothermic and hypothermic CPB, but blood loss was higher after normothermic CPB. Copyright (C) 2001 by W.B. Saunders Company.