J Extra Corpor Technol 2025, 57, 137--146 Ó The Author( s), published by EDP Sciences, 2025 https:// doi. org / 10.1051 / ject / 2025021
Available online at: ject. edpsciences. org
TECHNIQUE OR APPLICATION
Automated temperature management during cardiopulmonary bypass: a step toward safety and precision perfusion
Youssef El Dsouki( CCP) 1 and Ignazio Condello( PhD) 2,* 1 Université, Paris-Sorbonne, 27 rue Chaligny, 75012 Paris, France 2 University of Insubria, Via Ravasi, 2, 21100 Varese, VA, Italy
Received 12 March 2025, Accepted 20 May 2025
Abstract – Precise temperature management during cardiopulmonary bypass( CPB) is crucial for optimizing patient outcomes, and influencing metabolic rate, organ protection, and neurological integrity. Traditionally, temperature control during CPB has relied on manual adjustments by perfusionists, a practice fraught with potential for human error and variability in outcomes. Such variability can lead to severe complications, including cerebral hyperthermia and inflammatory responses, which significantly impact patient recovery and morbidity. This paper introduces a novel, fully automated temperature management system, which integrates with existing heater-cooler units( HCUs) and advanced perfusion systems to enhance precision and reliability. By utilizing real-time physiological monitoring and intelligent automation, the system dynamically adjusts temperature phases based on continuous patient feedback. Preliminary simulation data are presented to validate the system’ s feasibility and responsiveness. Ethical considerations regarding automated decision-making in surgery are also briefly discussed.
Key words: Cardiopulmonary bypass, Temperature management, Automated systems, Perfusion systems, Patient safety, Intelligent automation. Introduction
Cardiopulmonary bypass( CPB) is a critical component of cardiac surgery, enabling life-saving procedures by maintaining circulatory and respiratory support when the heart and lungs must be temporarily ceased. Despite the pivotal role of CPB in modern surgery, managing the patient’ s body temperature during such procedures remains a substantial challenge, with profound implications for patient outcomes [ 1 ]. Traditional temperature management during CPB relies predominantly on manual adjustments performed by perfusionists. This manual control, while experience-based, introduces a significant variability in patient outcomes, primarily due to the subjective nature of human decision-making and the potential for error. Such inconsistencies are not trivial; they are linked to serious complications, including cerebral hyperthermia, which can lead to neurological damage, and improper cooling or rewarming, which may exacerbate the inflammatory response following surgery [ 2 ]. Precise control of temperature is crucial because metabolic demands and the integrity of neurological and other organ functions are highly temperature-sensitive. Hypothermia, commonly induced during CPB, is intended to reduce metabolic rate and protect neurological functions by decreasing the oxygen needs
* Corresponding author: ignicondello @ hotmail. it of the brain and other critical organs [ 3, 4 ]. However, achieving and maintaining the correct degree of hypothermia, followed by a controlled rewarming phase, requires meticulous management to avoid the adverse effects of temperature fluctuations. The risks associated with suboptimal temperature control include not only neurological impairments but also coagulopathies, arrhythmias, and compromised immune functions, which collectively contribute to a complex postoperative recovery [ 5 ]. The introduction of automated systems in medical fields has consistently demonstrated enhanced outcomes through increased precision and reduced human error. In the context of CPB, an automated temperature management system could revolutionize standard practices by providing more consistent, precise, and safe temperature control [ 6, 7 ]. This paper proposes the development of such a system, integrating advanced sensor technologies and intelligent algorithms with existing perfusion and heater-cooler systems [ 1 ]. The goal is to automate the cooling and rewarming phases of CPB, leveraging real-time physiological data to dynamically adjust to the optimal temperature settings tailored to individual patient needs [ 8 ]. This innovative approach aims not only to standardize temperature management across surgical teams but also to enhance patient safety and improve clinical outcomes by reducing the variability inherent in manual processes. By discussing the integration of this technology, the paper explores its potential to set new benchmarks
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