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Ann Thorac Surg 2004;77:66-71
© 2004 The Society of Thoracic Surgeons

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Original article: cardiovascular

Early postoperative body temperature and developmental outcome after open heart surgery in infants

^a Department of Paediatric Intensive Care, Birmingham Children's Hospital, Steelehouse Lane, Birmingham, B4 6NH, United Kingdom
^b Department of Statistical Advisory Service, Birmingham Children's Hospital, Birmingham, United Kingdom
^c Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
^d Department of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
^e Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, , USA
^f Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
^g Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
^h Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA

Accepted for publication July 18, 2003.

^* Address reprint requests to Dr Morris, Pediatric Intensive Care Unit, Birmingham Children's Hospital, Steelehouse Lane, Birmingham, West Midlands B4 6NH, UK
e-mail: kevin.morris{at}bch.nhs.uk

BACKGROUND: Experimental data have suggested that early postoperative temperature management after cerebral ischemia may alter neurologic outcome. We explored whether minor deviations in early postoperative body temperature after infant heart surgery affects developmental outcome.

METHODS: In a study of infants undergoing repair of congenital heart disease, 95% of whom had a period of deep hypothermic circulatory arrest, postoperative temperature data were collected following cardiac surgery. Subjects were infants who had been enrolled in one of two prospective randomized single-center trials. Development was tested at age one year (the Bayley Scales of Infant Development) and at four years (Wechsler Preschool and Primary Scale of Intelligence, including Full Scale IQ, a Verbal IQ, and a Performance IQ).

RESULTS: Perioperative temperature data were reviewed in 329 patients, of whom 244 (74%) were evaluated at age one year and 156 (48%) were evaluated at four years. The temperature profile was recorded during the rewarming phase and for 36 hours postoperatively on the Intensive Care Unit. There were no significant associations between postoperative temperature and any of the neurodevelopmental tests at age one or four years. A further analysis assessing the percentage of time over specific temperature cutoff points of 37.5°C, 38°C, 38.5°C, and 39°C, revealed no significant effect.

CONCLUSIONS: Neurodevelopmental outcome at one and four years after repair of complex congenital heart disease was not significantly affected by the early postoperative body temperature profile of the infant when a management strategy aiming for normothermia is employed.

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