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British Journal of Anaesthesia, Vol 75, Issue 1 43-46, Copyright © 1995 by The Board of Management and Trustees of the British Journal of Anaesthesia


CLINICAL INVESTIGATIONS

Enoximone and warming after hypothermic cardiopulmonary bypass

DJR. Duthie, P. S. Woolman and A. R. Doyle
Department of Anaesthesia, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE; Clinical Physics Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF

In a randomized, controlled study of 24 patients undergoing myocardial revascularization, we found that enoximone 0.5 mg kg-1 i.v., followed by 5 micrograms kg-1 min-1, when rewarming after hypothermic cardiopulmonary bypass, prevented subsequent cooling of the periphery after transfer to the intensive care unit. Skin surface temperatures on the foot increased by mean 0.33 (SD 0.5) degree C h-1 in the enoximone group, but decreased by 0.43 (0.4) degree C h-1 in the control group until core temperature had increased to 37 degrees C (P < 0.001); only then did peripheral temperatures begin to increase in the control group. Enoximone did not merely redistribute heat from the core to the periphery. The capacity to transfer heat by the circulation rather than the ability to generate heat in the core appeared to limit body warming in the ICU after hypothermic cardiopulmonary bypass.
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