Hyperthermia after cardiac surgery

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
K AbeK Ohnishi

Abstract

To describe two cases of hyperthermia occurring after cardiac surgery. At the end of cardiopulmonary bypass, protamine was injected to reverse heparin. Following protamine, hypotension, pulmonary hypertension and hypoxia developed, but protamine induced hypotension recovered after administration of methyl predonisolone and catecholamines. Rectal temperature increased to 41 degrees C in the first case and 40 degrees C in the second after recovery from protamine induced hypotension. Arterial blood gas analysis, breathing 100% oxygen, showed severe acidosis and hypercapnia (pH 6.96, PaCO2 73 mmHg, PaO2 45 mmHg. BE -18 in the first case, and pH 7.13, PaCO2 59.9, PaO2 52.8, BE -11 in the second). At the same time, creatine phosphokinase levels showed 8400 u.L-1 in the first case and 4369 u.L-1 in the second. Serum and urine myoglobin concentrations were 334.2 ng.ml-1 and 1085 ng.ml-1, and 468 ng.ml-1 and 885 ng.ml-1, respectively. Efforts to cool the patients using alcohol were made. Following dantrolene (400 mg and 200 mg), the hyperthermia, acidosis, hypoxaemia and hypercarbia subsided (temperature 37.5 and 37.5 degrees C, PaO2 220 mmHg and 180 mmHg with 100% oxygen, PaCO2 35 mmHg and 41 mmHg respectively). Postoperatively, 20 mg....Continue Reading

References

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Citations

Nov 14, 2000·Forensic Science International : Synergy·B L ZhuH Maeda
Feb 20, 2002·Forensic Science International : Synergy·Bao-Li ZhuHitoshi Maeda
Mar 8, 2011·The Journal of Thoracic and Cardiovascular Surgery·Thomas MetterleinPeter Kranke
Mar 1, 2005·Forensic Science International : Synergy·Hajime Nishio, Koichi Suzuki
Jul 21, 2020·Annals of Cardiac Anaesthesia·Shvetank AgarwalManuel Castresana
Apr 12, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Annie Ting WangMichael Benggon

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