以质量求发展,以服务铸品牌

Journal of Nursing ›› 2021, Vol. 28 ›› Issue (5): 26-31.doi: 10.16460/j.issn1008-9969.2021.05.026

Previous Articles     Next Articles

Evidence Summary of Body Temperature Management in Cardiac Surgery with Extracorporeal Circulation

ZHOU Yi-fenga, YANG Ji-pinga, YUAN Haob, WU Juanc   

  1. a. Operating Room; b. Dept. of Clinical Laboratory; c. Dept. of Cardiology, Hunan Provincial People's Hospital, Changsha 410005, China
  • Received:2020-08-13 Online:2021-03-10 Published:2021-04-08

Abstract: Objective To retrieve and summarize the evidence on body temperature management in cardiac surgery with extracorporeal circulation, and to provide basis for clinical standardized intraoperative hypothermia treatment. Methods With PICO procedure, the research topic of “temperature management of patients undergoing cardiac surgery with extracorporeal circulation” was identified, then the search for eligible literature was conducted in China Guideline Network, National Guideline Clearinghouse, National Institute for Health and Care Excellence, Guidelines International Network, Scottish Intercollegiate Guidelines Network, UpToDate, BMJ-Best Practice, Cochrane Library, Pubmed, Web of Science , EMbase, CINAHL, China Biomedical Database, China Knowledge Network, Wanfang Medical Database and Medical Pulse Flux. The quality and grade of eligible studies were evaluated using the literature quality evaluation tool of AGREE 1I, AMSTAR 2 and GRADE. Results Twelve articles were included in this study, including 3 clinical practice guideline,2 evidence summary and 7 systematic reviews,and finally 17 pieces of evidence were extracted. Fifteen review indicators, including preoperative evaluation, pre-incubation, body temperature monitoring, and low temperature jump, shallow/medium temperature stop jump, cooling and rewarming rate of deep hypothermia circulation arrest surgery, peak, temperature gradient, and body temperature management during resuscitation were summarized. Conclusion Evidence should be applied based on the experience of medical staff, clinical situation and patient's wishes and should be updated in time to ensure scientific nursing for body temperature management in cardiac surgery with extracorporeal circulation so as to improve intraoperative care quality.

Key words: cardiac surgery, techniques in extracorporeal circulation, hypothermia treatment, body temperature management, evidence-based practice

CLC Number: 

  • R473.6
[1] Englum BR, He X, Gulack BC, et al.Hypothermia and Cerebral Protection Strategies in Aortic arch Surgery:a Comparative Effectiveness Analysis from the STS Adult Cardiac Surgery Database[J].Eur J Cardiothorac Surg, 2017, 52(3):492-498. DOI:10.1093/ejcts/ezx133.
[2] 王萍,高兴莲,余文静,等.深低温停循环大血管手术患者术中温度控制[J].护理学杂志,2017,32(12):43-45. DOI:10.3870/i.issn.1001-4152.2017.12.043.
[3] Lapar DJ, Baird CW.Surgical Considerations in Interrupted Aortic Arch[J].Semin Cardiothorac Vasc Anesth, 2018, 22(3):278-284. DOI:10.1177/1089253218776664.
[4] Okita Y, Miyata H,Motomura N, et al.A Study of Brain Protection During Total Arch Replacement Comparing Antegrade Cerebral Perfusion Versus Hypothermic Circulatory Arrest, with or without Retrograde Cerebral Perfusion: Analysis based on the Japan Adult Cardiovascular Surgery Database[J].J Thorac Cardiovasc Surg,2015,149(2S):S65-S73. DOI:10.1016/j.jtcvs.2014.08.070.
[5] Luehr M, Bachet J, Mohr FW, et al.Modern Temperature Management in Aortic Arch Surgery: the Dilemma of Moderate Hypothermia[J].Eur J Cardiothorac Surg, 2014, 45(1):27-39. DOI:10.1093/ejcts/ezt154.
[6] Stein LH, Rubinfeld G, Balsam LB.Too Cold to Clot Does Intraoperative Hypothermia Contribute to Bleeding After Aortic Surgery[J].Aorta, 2017, 5(4):106. DOI:10.12945/j.aorta.2017.16.049.
[7] Guo Z, Li X.2016 Survey about Temperature Management during Extracorporeal Circulation in China[J].Perfusion, 2017, 32(12):1-9. DOI:10.1177/0267659117736119.
[8] Dicenso A, Bayley L, Haynes RB.Accessing Pre-appraised Evidence: Fine-tuning the 5S Model into a 6S Model[J].Evid Based Nurs, 2009,12(4):99-101. DOI:10.1136/ebn.12.4.99-b.
[9] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: Advancing Guideline Development, Reporting and Evaluation in Health Care[J].J Clin Epidemiol, 2010, 63(12):1308-1311. DOI:10.1016/j.ypmed.2010.08.005.
[10] 张方圆,沈傲梅,曾宪涛,等.系统评价方法学质量评价工具AMSTAR 2解读[J].中国循证心血管医学杂志, 2018,10(1):14-18. DOI:1674-4055(2018)01-0014-05.
[11] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志, 2015,30(11):964-967. DOI:1002-6975(2015)11-0964-04.
[12] Engelman R, Baker RA, Likosky DS, et al.The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of Extra Corporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass--Temperature Management During Cardiopulmonary Bypass[J].J Extra Corpor Technol.2015,47(3):145-154. http://dx.doi.org/10.1016/j.athoracsur.2015.03.126.
[13] Reed H, Berg KB, Janelle GM.Aortic Surgery and Deep-hypothermic Circulatory Arrest:Anesthetic update[J].Semin Cardiothorac Vasc Anesth,2014,18(2):137-45. DOI:10.1177/1089253214525278.
[14] Fernando HC, Jaklitsch MT, Walsh GL, et al.The Society of Thoracic Surgeons Practice Guideline on the Prophylaxis and Management of Atrial Fibrillation Associated with General Thoracic Surgery: Executive Summary[J].Ann Thorac Surg,2011, 92(3):1144-1152. DOI:10.1016/j.athoracsur.2011.06.104.
[15] Fan S, Wang D, Wu C, et al.Effects of 4 Major Brain Protection Strategies during Aortic Arch Surgery: A Protocol for a Systematic Review and Network Meta-analysis Using Stata[J].Medicine,2018,97(27):e11448. DOI:doi.org/10.1097/MD.0000000000011448.
[16] Grigore AM, Murray CF, Ramakrishna H, et al.A Core Review of Temperature Regimens and Neuroprotection during Cardiopulmonary Bypass: Does Rewarming Rate Matter?[J].Anesth Analg, 2009, 109(6):1741-1751. DOI:10.1213/ANE.0b013e3181c04fea.
[17] Fernández Suárez FE, Fernández Del VD, González AA, et al.Intraoperative Care for Aortic Surgery Using Circulatory Arrest[J].J Thorac Dis, 2017, 9(Suppl 6):S508-S520. DOI:10.21037/jtd.2017.04.67.
[18] Linardi D, Faggian G, Rungatscher A.Temperature Management During Circulatory Arrest in Cardiac Surgery[J].Ther Hypothermia Temp Manag, 2016, 6(1):9-16. DOI:10.1089/ther.2015.0026.
[19] Ho KM, Tan JA.Benefits and Risks of Maintaining Normothermia during Cardiopulmonary Bypass in Adult Cardiac Surgery:a Systematic Review[J].Cardiovasc Ther, 2011, 29(4):260-279. DOI:10.1111/j.1755-5922.2009.00114.x.
[20] Xiong Y, Sun Y, Ji B, et al.Systematic Review and Meta‐Analysis of Benefits and Risks between Normothermia and Hypothermia during Cardiopulmonary Bypass in Pediatric Cardiac Surgery[J].Pediatric Anesthesia,2015, 25(2):135-142. DOI:10.1111/pan.12560.
[21] Murphy GS, Hessel EA, Groom RC.Optimal Perfusion during Cardiopulmonary Bypass: an Evidence-based Approach[J].Anesth Analg,2009, 108(5):1394-1417. DOI:10.1213/ane.0b013e3181875e2e.
[22] Eric F.Inadvertent Perioperative Hypothermia: Prevention and Management.The Joanna Briggs Institute (JBI) EBP[J].Database Rev,2017(9):27-28.CD:JBI1718.
[23] Gupta P, Harky A, Jahangeer S, et al.Varying Evidence on Deep Hypothermic Circulatory Arrest in Thoracic Aortic Aneurysm Surgery[J].Tex Heart Inst J,2018,45(2):70-75. DOI:org/10.14503/THIJ-17-6364.
[24] Madrid E, Urrútia G, Figuls M, et al.Active Body Surface Warming Systems for Preventing Complications Caused by Inadvertent Perioperative Hypothermia in Adults[J].Cochrane Database Syst Rev,2016(4):CD009016. DOI:10.1002/14651858.CD009016.pub2.
[25] Alderson P, Campbell G,Smith AF,et al.Thermal Insulation for Preventing Inadvertent Perioperative Hypothermia[J].Cochrane Database Syst Rev, 2014(6):CD009908. DOI:10.1002/14651858.CD009908.pub2.
[26] Griepp RB, Di LG.Hypothermia for Aortic Surgery[J].J Thorac Cardiovasc Surg,2013,145(3):S56-S58. DOI:10.1016/j.jtcvs.2012.11.072.
[27] National Institute for Health and Care Excellence.Hypothermia: Prevention and Management in Adults Having Surgery[EB/OL].(2016-12-01)[2019-12-10]. https://www.nice.org.uk/guidance/cg65/chapter/Update-information.
[28] Hooper VD, Chard R, Clifford T, et al.ASPAN's Evidence-based Clinical Practice Guideline for the Promotion of Perioperative Normothermia: Second Edition[J].J Perianesth Nurs,2010,25(6):346-365. DOI:10.1016/j.jopan.2010.10.006.
[29] 章明阳,杜李百合,罗小平,等.术前患者预保温的最佳证据总结[J].护理学报, 2020, 27(6):17-22. DOI:10.16460/j.issn1008-9969.2020.06.017.
[30] Yancy C, Heather J.Preoperative Pre-warming Versus No Preoperative Pre-warming and Intraoperative Hypothermia: An Evidence-based Practice Analysis[EB/OL].(2019-08-21)[2019-12-10]. https://sigma.nursingrepository.org/handle/107 55/18299.
[31] Kalisvaart ACJ, Prokop BJ, Colbourne F.Hypothermia:Impacton Plasticity Following Brain Injury[J].Brain Circ,2019,5(4):169-178. DOI:10.4103/bc.bc_21_19.
[32] Yan TD, Bannon PG, Bavaria J, et al.Consensus on Hypother-mia in Aortic Arch Surgery[J].Ann Cardiothorac Surg,2013,2(2):163-168. DOI:10.3978/j.issn.2225-319X.2013.03.03.
[33] 易秋月,杨阳,周和平,等.深度低温与中度低温在主动脉手术中的应用[J].中国心血管病研究,2019,17(9):822-825. DOI:10.3969/j.issn.1672-5301.2019.09.013.
[1] XIA Bi-yun, Chen Yu, WU Yan-yan, Hu Yan. Evidence-based practice to reduce incidence of radial artery occlusion in elderly patients after transradial coronary intervention [J]. Journal of Nursing, 2025, 32(2): 37-43.
[2] GUAN Yan, CHEN Chen, SU Yun-yan, JIN Hua, XIE Xiao-li, HU Yue-xiu, WANG Zhe-yun. Construction of training program for cardiac surgery nurse specialists based on Taylor model [J]. Journal of Nursing, 2024, 31(18): 67-72.
[3] LIU Yao, ZHAN Xin, XIE Ting-ping, CHEN Wei, HU Yi-yang, YANG Cui-na, ZHANG Guo-zhong. Evidence-based practice of early mobilization in patients with femoral artery compression hemostat after cerebral angiography [J]. Journal of Nursing, 2024, 31(15): 29-33.
[4] DENG Ying-yi, CHENG Lu-ying, GONG Xi-yan, WANG Min, LIAO Dong-xia, ZHANG Cui-cui, DING Juan, GU Qing-lu, LIAO Chang-ju. Evidence-based practice of clinical nursing handover: a scoping review [J]. Journal of Nursing, 2024, 31(14): 57-62.
[5] JIANG Ya-qian, CHEN Zhao, XU Hai-yan, WU Qian-sheng, ZHOU Yan-rong. Effect and effective duration of prone ventilation in patients with acute respiratory distress [J]. Journal of Nursing, 2023, 30(9): 60-63.
[6] HUANG Yu-xing, LIU Ning, HUANG Ting. Construction of evidence-based practice teaching index system for nursing undergraduates in low-to-medium resource areas based on core competency [J]. Journal of Nursing, 2023, 30(13): 24-28.
[7] YAO jing-jing, LIU Ying, XU Hui-juan, SUN Si-min, CHEN Min, JIANG Xue-jie. Prevention and Management of Chemotherapy-induced Constipation in Patients with Acute Leukemia: A Evidence-based Nursing Practice Project [J]. Journal of Nursing, 2022, 29(8): 40-45.
[8] ZHOU Yi-feng, YANG Ji-ping, PENG Yao-li, YUAN Hao, SHI Ze-ya. Evidence-based Body Temperature Management in Cardiopulmonary Bypass Surgery [J]. Journal of Nursing, 2022, 29(3): 40-45.
[9] HOU xiang-chuan, WU yan-ting, ZHOU kai-qi, MO yi-jian, HUANG li-xiang, LIU yi-sha. Best Evidence-based Practice for Improving Qualified Rate of Sputum Collection in Patients with with Respiratory Diseases [J]. Journal of Nursing, 2022, 29(24): 43-48.
[10] HU Kai-li, YANG Si-yu, WU Qian-sheng, ZHOU Yan-rong. Construction of Risk Prediction Model for Prolonged Mechanical Ventilation in Patients after Cardiac Surgery [J]. Journal of Nursing, 2022, 29(20): 60-64.
[11] DENG Ying-ying, PEI Hua-qing, REN Ying, YIN Chun-mei, WEN Mei, ZHANG Xiao-ling. Evidence-based Practice of Prevention of PICC-related Venous Thrombosis in Critically Ill Neurosurgical Patients [J]. Journal of Nursing, 2022, 29(11): 36-40.
[12] GUAN Yan, LU Shan, YE Jia-xin, WANG Zhe-yun. Construction and Application of Standardized Practice Scheme for Pressure Injury after Cardiac Surgery [J]. Journal of Nursing, 2021, 28(7): 15-20.
[13] WANG Xiao-yan, LI Mu-ling, XIE Ting-ping, ZHUANG Zhuo-xun, HE Shui-xiu, ZHEN Xiao-xia, ZHU Jing-wen, LU Yun-tao, ZHOU Hong-zhen. Evidence-based Practice of Optimal Bed Rest Time after Lumbar Puncture for Neurosurgcial Patients [J]. Journal of Nursing, 2021, 28(4): 31-35.
[14] WANG Yan, WANG Zhe-yun, YE Jia-xin, GUAN Yan, YU Yun, LU Shan. Effect of Different Preset Temperature of Cooling Blanket on Cooling Effect and Complications after Cardiac Surgery [J]. Journal of Nursing, 2021, 28(21): 67-70.
[15] WANG Rui-na, LAI Xiao-fan, HUANG Bin-ying, LI Yan, ZHANG Rui. Evidence-based Nursing Practice of Unplanned Extubation of Inpatients with Nasal Tube Feeding [J]. Journal of Nursing, 2021, 28(19): 44-47.
Viewed
Full text


Abstract

Cited

  Shared   
No Suggested Reading articles found!