Hypothermic Cardiopulmonary Bypass Weaning and Prolonged Postoperative Rewarming in a Patient With Intraoperative Oxygenator Thrombosis

THE INCIDENCE OF oxygenator thrombosis during cardiopulmonary bypass (CPB) has decreased significantly with
the advent of modern heparin-coated bypass circuits, but rare failures continue to be reported at a rate of 50 to 133 cases per year in the United States.1–3 Oxygenator thrombosis is considered to be a serious, and potentially lethal, complication that requires CPB cessation and subsequent membrane oxygenator change-out.2
Mild operative hypothermia (32º-34ºC) and controlled rewarming gradients are commonplace practices in modern
CPB that afford a degree of neuroprotection from ischemic damage by avoiding perioperative hyperthermia, but the
potential benefits of slow rewarming rates and hypothermic CPB weaning remain controversial.4–7 The authors report a case of CPB membrane oxygenator failure managed with rapid oxygenator replacement, operative hypothermia, and prolonged postoperative rewarming.
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