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Highest core temperature during cardiopulmonary bypass and rate of mediastinitis

Maine Medical Center, Portland, ME, USA, GROOMR{at}mmc.org

Athos J Rassias

Dartmouth Hitchcock Medical Center, Lebanon, NH, USA

John E Cormack

Maine Medical Center, Portland, ME, USA

Gordon R DeFoe

Dartmouth Hitchcock Medical Center, Lebanon, NH, USA

Christian DioDato

Concord Hospital, Concord, NH, USA

Charles K Krumholz

Fletcher Allen Health Care, Burlington, VT, USA

Richard J Forest

Maine Medical Center, Portland, ME, USA

John W Pieroni

Catholic Medical Center, Manchester, NH, USA

Brian O’Connor

Beth Israel Deaconess Medical Center, Boston, MA, USA

Craig S Warren

Eastern Maine Medical Center, Bangor, ME, USA

Elaine M Olmstead

Dartmouth Medical School, Hanover, NH, USA

Cathy S Ross

Dartmouth Medical School, Hanover, NH, USA

Gerald T O’Connor

Dartmouth Medical School, Hanover, NH, USA

Northern New England Cardiovascular Disease Study Group

Temperature control during cardiopulmonary bypass (CPB) may be related to rates of bacterial infection. We assessed the relationship between highest core temperature during CPB and rates of mediastinitis in 6955 consecutive isolated coronary artery bypass graft (CABG) procedures in northern New England.

The overall rate of mediastinitis was 1.1%. The association between highest core temperature and mediastinitis was different for diabetics than for nondiabetics. A multivariate model showed that there was a significant interaction between diabetes and temperature in their association with mediastinitis (p = 0.015). Diabetic patients showed higher rates of mediastinitis as highest core temperature increased, from 0.7% in the 37°C group to 3.3% in the 38°C group (p _trend = 0.002). Adjusted rates were similar. Nondiabetic patients did not show this trend (p _trend = 0.998).

Among diabetic patients, a peak core body temperature > 37.9°C during CPB is a significant risk factor for development of mediastinitis. Avoidance of higher temperatures during CPB may lower the risk of mediastinitis for diabetic patients undergoing CABG surgery.

Perfusion, Vol. 19, No. 2, 119-125 (2004)
DOI: 10.1191/0267659104pf731oa


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