EFFECTS OF HYPOTHERMIA ON SOMATOSENSORY EVOKED RESPONSES IN MAN

Abstract

Somatosensory evoked responses after median nerve stimulation were recorded in 21 patients during hypothermic cardiopulmonary bypass. During hypothermia a significant linear correlation (P less than 0.001) was found between evoked potential latency and temperature. Correlation was best for tympanic membrane temperature during cooling and for perfusate temperature (arterial, venous) during rewarming. The increase in latency was more pronounced for middle latency components (N2, N3) and for the early cortical N1 than for the cervical N0 and central conduction time. In all patients N1 was detectable at 26 degrees C, with slightly reduced amplitude. In the rewarming period the changes occurred in the reverse order and pre-bypass values were achieved at normothermia. The slopes of the regression lines were different during cooling and rewarming, when latencies were related to patient (tympanic, nasopharyngeal, rectal) temperature, but identical when arterial or venous blood temperature was used as the reference. No correlation was found between latency and perfusion pressure. We conclude that sophisticated temperature measurement is required to aid the interpretation of evoked responses used during hypothermia.