Perioperative hypothermia (33°C) does not increase the occurrence of cardiovascular events in patients undergoing cerebral aneurysm surgery: Findings from the intraoperative hypothermia for aneurysm surgery trial

Hoang P. Nguyen, Jonathan G. Zaroff, Emine O. Bayman, Adrian W. Gelb, Michael Todd, Bradley J. Hindman, IHAST-MIDS and IHAST Investigators

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Perioperative hypothermia has been reported to increase the occurrence of cardiovascular complications. By increasing the activity of sympathetic nervous system, perioperative hypothermia also has the potential to increase cardiac injury and dysfunction associated with subarachnoid hemorrhage. Methods: The Intraoperative Hypothermia for Aneurysm Surgery Trial randomized patients undergoing cerebral aneurysm surgery to intraoperative hypothermia (n = 499, 33.3° ± 0.8°C) or normothermia (n = 501, 36.7° ± 0.5°C). Cardiovascular events (hypotension, arrhythmias, vasopressor use, myocardial infarction, and others) were prospectively followed until 3-month follow-up and were compared in hypothermic and normothermic patients. A subset of 62 patients (hypothermia, n = 33; normothermia, n = 29) also had preoperative and postoperative (within 24 h) measurement of cardiac troponin-I and echocardiography to explore the association between perioperative hypothermia and subarachnoid hemorrhage-associated myocardial injury and left ventricular function. Results: There was no difference between hypothermic and normothermic patients in the occurrence of any single cardiovascular event or in composite cardiovascular events. There was no difference in mortality (6%) between groups, and there was only a single primary cardiovascular death (normothermia). There was no difference between hypothermic and normothermic patients in postoperative versus preoperative left ventricular regional wall motion or ejection fraction. Compared with preoperative values, hypothermic patients had no postoperative increase in cardiac troponin-I (median change 0.00 μg/l), whereas normothermic patients had a small postoperative increase (median change + 0.01 μg/l, P = 0.038). Conclusion: In patients undergoing cerebral aneurysm surgery, perioperative hypothermia was not associated with an increased occurrence of cardiovascular events.

Original languageEnglish
Pages (from-to)327-342
Number of pages16
JournalAnesthesiology
Volume113
Issue number2
DOIs
Publication statusPublished - Aug 2010
Externally publishedYes

Cite this

Nguyen, Hoang P. ; Zaroff, Jonathan G. ; Bayman, Emine O. ; Gelb, Adrian W. ; Todd, Michael ; Hindman, Bradley J. ; IHAST-MIDS and IHAST Investigators. / Perioperative hypothermia (33°C) does not increase the occurrence of cardiovascular events in patients undergoing cerebral aneurysm surgery : Findings from the intraoperative hypothermia for aneurysm surgery trial. In: Anesthesiology. 2010 ; Vol. 113, No. 2. pp. 327-342.
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title = "Perioperative hypothermia (33°C) does not increase the occurrence of cardiovascular events in patients undergoing cerebral aneurysm surgery: Findings from the intraoperative hypothermia for aneurysm surgery trial",
abstract = "Background: Perioperative hypothermia has been reported to increase the occurrence of cardiovascular complications. By increasing the activity of sympathetic nervous system, perioperative hypothermia also has the potential to increase cardiac injury and dysfunction associated with subarachnoid hemorrhage. Methods: The Intraoperative Hypothermia for Aneurysm Surgery Trial randomized patients undergoing cerebral aneurysm surgery to intraoperative hypothermia (n = 499, 33.3° ± 0.8°C) or normothermia (n = 501, 36.7° ± 0.5°C). Cardiovascular events (hypotension, arrhythmias, vasopressor use, myocardial infarction, and others) were prospectively followed until 3-month follow-up and were compared in hypothermic and normothermic patients. A subset of 62 patients (hypothermia, n = 33; normothermia, n = 29) also had preoperative and postoperative (within 24 h) measurement of cardiac troponin-I and echocardiography to explore the association between perioperative hypothermia and subarachnoid hemorrhage-associated myocardial injury and left ventricular function. Results: There was no difference between hypothermic and normothermic patients in the occurrence of any single cardiovascular event or in composite cardiovascular events. There was no difference in mortality (6{\%}) between groups, and there was only a single primary cardiovascular death (normothermia). There was no difference between hypothermic and normothermic patients in postoperative versus preoperative left ventricular regional wall motion or ejection fraction. Compared with preoperative values, hypothermic patients had no postoperative increase in cardiac troponin-I (median change 0.00 μg/l), whereas normothermic patients had a small postoperative increase (median change + 0.01 μg/l, P = 0.038). Conclusion: In patients undergoing cerebral aneurysm surgery, perioperative hypothermia was not associated with an increased occurrence of cardiovascular events.",
author = "Nguyen, {Hoang P.} and Zaroff, {Jonathan G.} and Bayman, {Emine O.} and Gelb, {Adrian W.} and Michael Todd and Hindman, {Bradley J.} and {IHAST-MIDS and IHAST Investigators} and P. Myles and J. Rosenfeld and S. Cairo and J. Smart and H. Machlin and J. Moloney and A. Silvers and G. Downey and D. McIlroy and D. Daly",
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Perioperative hypothermia (33°C) does not increase the occurrence of cardiovascular events in patients undergoing cerebral aneurysm surgery : Findings from the intraoperative hypothermia for aneurysm surgery trial. / Nguyen, Hoang P.; Zaroff, Jonathan G.; Bayman, Emine O.; Gelb, Adrian W.; Todd, Michael; Hindman, Bradley J.; IHAST-MIDS and IHAST Investigators.

In: Anesthesiology, Vol. 113, No. 2, 08.2010, p. 327-342.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Perioperative hypothermia (33°C) does not increase the occurrence of cardiovascular events in patients undergoing cerebral aneurysm surgery

T2 - Findings from the intraoperative hypothermia for aneurysm surgery trial

AU - Nguyen, Hoang P.

AU - Zaroff, Jonathan G.

AU - Bayman, Emine O.

AU - Gelb, Adrian W.

AU - Todd, Michael

AU - Hindman, Bradley J.

AU - IHAST-MIDS and IHAST Investigators

AU - Myles, P.

AU - Rosenfeld, J.

AU - Cairo, S.

AU - Smart, J.

AU - Machlin, H.

AU - Moloney, J.

AU - Silvers, A.

AU - Downey, G.

AU - McIlroy, D.

AU - Daly, D.

PY - 2010/8

Y1 - 2010/8

N2 - Background: Perioperative hypothermia has been reported to increase the occurrence of cardiovascular complications. By increasing the activity of sympathetic nervous system, perioperative hypothermia also has the potential to increase cardiac injury and dysfunction associated with subarachnoid hemorrhage. Methods: The Intraoperative Hypothermia for Aneurysm Surgery Trial randomized patients undergoing cerebral aneurysm surgery to intraoperative hypothermia (n = 499, 33.3° ± 0.8°C) or normothermia (n = 501, 36.7° ± 0.5°C). Cardiovascular events (hypotension, arrhythmias, vasopressor use, myocardial infarction, and others) were prospectively followed until 3-month follow-up and were compared in hypothermic and normothermic patients. A subset of 62 patients (hypothermia, n = 33; normothermia, n = 29) also had preoperative and postoperative (within 24 h) measurement of cardiac troponin-I and echocardiography to explore the association between perioperative hypothermia and subarachnoid hemorrhage-associated myocardial injury and left ventricular function. Results: There was no difference between hypothermic and normothermic patients in the occurrence of any single cardiovascular event or in composite cardiovascular events. There was no difference in mortality (6%) between groups, and there was only a single primary cardiovascular death (normothermia). There was no difference between hypothermic and normothermic patients in postoperative versus preoperative left ventricular regional wall motion or ejection fraction. Compared with preoperative values, hypothermic patients had no postoperative increase in cardiac troponin-I (median change 0.00 μg/l), whereas normothermic patients had a small postoperative increase (median change + 0.01 μg/l, P = 0.038). Conclusion: In patients undergoing cerebral aneurysm surgery, perioperative hypothermia was not associated with an increased occurrence of cardiovascular events.

AB - Background: Perioperative hypothermia has been reported to increase the occurrence of cardiovascular complications. By increasing the activity of sympathetic nervous system, perioperative hypothermia also has the potential to increase cardiac injury and dysfunction associated with subarachnoid hemorrhage. Methods: The Intraoperative Hypothermia for Aneurysm Surgery Trial randomized patients undergoing cerebral aneurysm surgery to intraoperative hypothermia (n = 499, 33.3° ± 0.8°C) or normothermia (n = 501, 36.7° ± 0.5°C). Cardiovascular events (hypotension, arrhythmias, vasopressor use, myocardial infarction, and others) were prospectively followed until 3-month follow-up and were compared in hypothermic and normothermic patients. A subset of 62 patients (hypothermia, n = 33; normothermia, n = 29) also had preoperative and postoperative (within 24 h) measurement of cardiac troponin-I and echocardiography to explore the association between perioperative hypothermia and subarachnoid hemorrhage-associated myocardial injury and left ventricular function. Results: There was no difference between hypothermic and normothermic patients in the occurrence of any single cardiovascular event or in composite cardiovascular events. There was no difference in mortality (6%) between groups, and there was only a single primary cardiovascular death (normothermia). There was no difference between hypothermic and normothermic patients in postoperative versus preoperative left ventricular regional wall motion or ejection fraction. Compared with preoperative values, hypothermic patients had no postoperative increase in cardiac troponin-I (median change 0.00 μg/l), whereas normothermic patients had a small postoperative increase (median change + 0.01 μg/l, P = 0.038). Conclusion: In patients undergoing cerebral aneurysm surgery, perioperative hypothermia was not associated with an increased occurrence of cardiovascular events.

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U2 - 10.1097/ALN.0b013e3181dfd4f7

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JF - Anesthesiology

SN - 0003-3022

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