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J Thorac Cardiovasc Surg 1999;117:156-163
© 1999 Mosby, Inc.
CARDIOPULMONARY SUPPORT AND PHYSIOLOGY |
From the Departments of Anesthesiology, Cardiothoracic Surgery, and Rehabilitation Medicine, The Mount Sinai–New York University Medical Center, and the Department of Neurology, Albert Einstein College of Medicine, New York, NY.
Read at the Seventy-eighth Annual Meeting of The American Association for Thoracic Surgery, Boston, Mass, May 3-6, 1998.
Received for publication May 8, 1998. Revisions requested June 29, 1998. Revisions received July 29, 1998. Accepted for publication Sept 14, 1998. Address for reprints: David L. Reich, MD, Department of Anesthesiology, Box 1010, The Mount Sinai-New York University Medical Center, One Gustave L. Levy Place, New York, NY 10029-6574.
Introduction: Pediatric patients undergoing prolonged periods of deep hypothermic circulatory arrest have been found to experience long-term deficits in cognitive function. However, there is limited information of this type in adult patients who are undergoing deep hypothermic circulatory arrest for thoracic aortic repairs.
Methods: One hundred forty-nine patients undergoing elective cardiac or thoracic aortic operations were evaluated preoperatively; 106 patients were evaluated early in the postoperative period (EARLY), and 77 patients were evaluated late in the postoperative period (LATE) with a battery of neuropsychologic tests. Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep hypothermic circulatory arrest were divided into 2 subgroups: those with 1 to 24 minutes of deep hypothermic circulatory arrest (n = 36 patients) and those with 25 minutes or more of deep hypothermic circulatory arrest (n = 40 patients). The neuropsychologic test battery consisted of 8 tests encompassing 5 domains: attention, processing speed, memory, executive function, and fine motor function. Data were normalized to baseline values, and changes from baseline were analyzed by analysis of covariance, multivariate logistic regression, and survival functions.
Results: In all domains, poor performance or inability to be tested EARLY were significant predictors of poor performance LATE (odds ratio, 5.27; P < .01). Deep hypothermic circulatory arrest of 25 minutes or more and advanced age were significant predictors of poor performance LATE for the memory and fine motor domains. Deep hypothermic circulatory arrest of 25 minutes or more (odds ratio, 4.0; P = .02) was a determinant of prolonged hospital stay (>21 days).
Conclusion: Deep hypothermic circulatory arrest of 25 minutes or more and advanced age were associated with memory and fine motor deficits and with prolonged hospital stay.
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|
|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
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|
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|
|
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T. Ueda, H. Shimizu, T. Ito, I. Kashima, K. Hashizume, Y. Iino, and S. Kawada Cerebral complications associated with selective perfusion of the arch vessels Ann. Thorac. Surg., November 1, 2000; 70(5): 1472 - 1477. [Abstract] [Full Text] [PDF]
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M. P. Ehrlich, M. A. Ergin, J. N. McCullough, S. L. Lansman, J. D. Galla, C. A. Bodian, A. Z. Apaydin, and R. B. Griepp Predictors of adverse outcome and transient neurological dysfunction after ascending aorta/hemiarch replacement Ann. Thorac. Surg., June 1, 2000; 69(6): 1755 - 1763. [Abstract] [Full Text] [PDF]
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M. A. Ergin, S. Uysal, D. L. Reich, A. Apaydin, S. L. Lansman, J. N. McCullough, and R. B. Griepp Temporary neurological dysfunction after deep hypothermic circulatory arrest: a clinical marker of long-term functional deficit Ann. Thorac. Surg., June 1, 1999; 67(6): 1887 - 1890. [Abstract] [Full Text] [PDF]
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J. N. McCullough, N. Zhang, D. L. Reich, T. S. Juvonen, J. J. Klein, D. Spielvogel, M. A. Ergin, and R. B. Griepp Cerebral metabolic suppression during hypothermic circulatory arrest in humans Ann. Thorac. Surg., June 1, 1999; 67(6): 1895 - 1899. [Abstract] [Full Text] [PDF]
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