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International Society For Minimally Invasive Cardiothoracic Surgery

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Normothermia In Minimally Invasive Cardiac Surgery.
Luis Ruben Barragan Garate1, Ignacio Salazar Hernandez2.
1Hospital General de Puebla, Puebla, Mexico, 2General Hospital of Mexico, Mexico City, Mexico.

BACKGROUND - The principles of cardiopulmonary bypass with normothermia consist of maintaining a flow of 3.5 l.min.m2, nasopharyngeal and rectal temperature between 35.0 and 36.5 C, hematocrit greater than 30% during shunt. Generating with this the conditions close to physiological where the systematic flow is 3.0 -5 l. min. m2. The use of this technique with favorable results in relation to morbidity and mortality has been investigated in pediatric patients with non-complex congenital heart disease. The use of hypothermia in patients with ischemic heart disease does not have advantages over normothermia in cardiopulmonary bypass in terms of cerebral, renal and pulmonary protection, the use of cardiopulmonary bypass with hypothermia has been considered as an effective way to perform procedures cardiac.METHODS - We present the initial experience in the use of normothermia in cardiac surgery in a total of 20 patients operated during the period from July 2017 to July 2018 among the most frequent conditions is valvular pathology followed by congenital defects type interatrial communication.
RESULTS Femoral cannulation was performed in all cases with the support of tranesophageal ultrasound, with selective intubation with a left double lumen orotracheal tube, initiating cardioulmponary bypass, maintaining systemic temperature between 36 and 36.5 degrees in all cases, myocardial protection with cardioplegia of the modified nest by administering it in advance. in all cases.CONCLUSIONS The normothermia in cardiac surgery has demonstrated benefits such as the decrease in post-surgical bleeding, decrease in the administration of post-surgical vasoactive agents less days of stay in the intensive care unit as well as shorter hospital stay.


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