The Effect of Normothermia and Moderate Hypothermia Cardiopulmonary Bypass on Early Clinical Outcomes in Low-Risk Pediatrics Undergoing Congenital Heart Defects Surgery

Abstract

Background: The optimal temperature strategy during cardiopulmonary bypass (CPB) remains a topic of debate. Objectives: This study investigates the effects of normothermia and moderate hypothermia during CPB on early clinical outcomes in congenital heart defect surgery. Methods: In this prospective, randomized cohort study, 120 patients with congenital heart defects classified as risk adjustment for congenital heart surgery (RACHS) I-II were enrolled. The participants were divided into two groups: Sixty patients underwent normothermic CPB, and 60 underwent moderate hypothermic CPB. The primary clinical outcomes assessed were the vasoactive inotropic score (VIS), weaning time from mechanical ventilation, and lengths of ICU and hospital stays. Statistical analyses were conducted using SPSS software version 26.0, with a significance level set at P < 0.05. Results: The analysis of primary outcomes revealed that patients in the normothermic group had significantly lower VIS, shorter ICU stays, and reduced weaning times from mechanical ventilation compared to the moderate hypothermic group (P < 0.001). Additionally, other clinical outcomes, including CPB time (P < 0.001), glomerular filtration rate (GFR) at 24 hours post-ICU admission (P = 0.024), thoracic blood loss (P < 0.001), blood product transfusion requirements (P < 0.001), and several hematologic laboratory findings (P < 0.05), demonstrated statistically significant differences between the two groups. Conclusions: Based on the clinical outcomes observed in this study, a normothermic CPB strategy appears to be optimal for low-risk pediatric patients undergoing congenital heart disease surgery.