| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;69:1077-1083
© 2000 The Society of Thoracic Surgeons
a Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
b Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
Address reprint requests to Dr Hill, Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710
e-mail: hill0012{at}mc.duke.edu
Background. The impact of alterable physiologic variables on neurologic outcome after coronary artery bypass grafting procedures is unknown. The purpose of this study was to determine whether minimum intraoperative hematocrit, maximum glucose concentration, or mean arterial pressure during cardiopulmonary bypass influences risk-adjusted neurologic outcome after coronary artery bypass grafting.
Methods. Outcome data from 2,862 patients undergoing coronary artery bypass grafting were merged with intraoperative physiologic data. A preoperative stroke risk index was calculated for each patient. Variables found significant by univariate logistic regression were tested in a multivariable model to determine association with outcome.
Results. The incidence of stroke or coma in the study population was 1.3%. After controlling for stroke risk and bypass time, only an index of low mean arterial pressure during bypass retained a significant inverse association with outcome (p = 0.0304).
Conclusions. This study found no evidence that glucose concentration or minimum hematocrit are associated with major adverse neurologic outcome. The association between lower pressure during bypass and decreased incidence of stroke or coma persisted in all risk groups. This points to mechanisms other than hypoperfusion as the primary cause of neurologic injury associated with cardiac surgery.
This article has been cited by other articles:
|
|
 |
|
  K. Nishiyama, M. Horiguchi, S. Shizuta, T. Doi, N. Ehara, R. Tanuguchi, Y. Haruna, Y. Nakagawa, Y. Furukawa, M. Fukushima, et al. Temporal Pattern of Strokes After On-Pump and Off-Pump Coronary Artery Bypass Graft Surgery. Ann. Thorac. Surg., June 1, 2009; 87(6): 1839 - 1844. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. S. Murphy, E. A. Hessel II, and R. C. Groom Optimal Perfusion During Cardiopulmonary Bypass: An Evidence-Based Approach Anesth. Analg., May 1, 2009; 108(5): 1394 - 1417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Puskas, H. P. Grocott, W. D. White, J. P. Mathew, M. F. Newman, and S. Bar-Yosef Intraoperative Hyperglycemia and Cognitive Decline After CABG Ann. Thorac. Surg., November 1, 2007; 84(5): 1467 - 1473. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Schoof, W. Lubahn, M. Baeumer, R. Kross, C.-W. Wallesch, A. Kozian, C. Huth, and M. Goertler Impaired cerebral autoregulation distal to carotid stenosis/occlusion is associated with increased risk of stroke at cardiac surgery with cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 690 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Selim Perioperative Stroke N. Engl. J. Med., February 15, 2007; 356(7): 706 - 713. [Full Text] [PDF]
|
|
|
|
|
|
G. J. Murphy and G. D. Angelini Indications for Blood Transfusion in Cardiac Surgery Ann. Thorac. Surg., December 1, 2006; 82(6): 2323 - 2334. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Hogue Jr, C. A. Palin, and J. E. Arrowsmith Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices. Anesth. Analg., July 1, 2006; 103(1): 21 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Baker, L. J. Hallsworth, and J. L. Knight Stroke After Coronary Artery Bypass Grafting Ann. Thorac. Surg., November 1, 2005; 80(5): 1746 - 1750. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Karkouti, G. Djaiani, M. A. Borger, W. S. Beattie, L. Fedorko, D. Wijeysundera, J. Ivanov, and J. Karski Low Hematocrit During Cardiopulmonary Bypass is Associated With Increased Risk of Perioperative Stroke in Cardiac Surgery Ann. Thorac. Surg., October 1, 2005; 80(4): 1381 - 1387. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Y. Gandhi, G. A. Nuttall, M. D. Abel, C. J. Mullany, H. V. Schaff, B. A. Williams, L. M. Schrader, R. A. Rizza, and M. M. McMahon Intraoperative Hyperglycemia and Perioperative Outcomes in Cardiac Surgery Patients Mayo Clin. Proc., July 1, 2005; 80(7): 862 - 866. [Abstract] [PDF]
|
|
|
|
|
|
R. A. Jonas, D. Wypij, S. J. Roth, D. C. Bellinger, K. J. Visconti, A. J. du Plessis, H. Goodkin, P. C. Laussen, D. M. Farrell, J. Bartlett, et al. The influence of hemodilution on outcome after hypothermic cardiopulmonary bypass: results of a randomized trial in infants J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1765 - 1774. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Dworschak, M. Czerny, M. Grimm, G. Grubhofer, and W. Plochl The impact of asymptomatic carotid artery disease on the intraoperative course of coronary artery bypass surgery Perfusion, January 1, 2003; 18(1): 15 - 18. [Abstract] [PDF]
|
|
|
|
 |
|
 L. K. Ti, J. P. Mathew, G. B. Mackensen, H. P. Grocott, W. D. White, J. G. Reves, and M. F. Newman Effect of Apolipoprotein E Genotype on Cerebral Autoregulation During Cardiopulmonary Bypass Stroke, July 1, 2001; 32(7): 1514 - 1519. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
