HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Andrew, M.J. Articles by Knight, J.L. Search for Related Content PubMed Articles by Andrew, M.J. Articles by Knight, J.L.

Ann Thorac Surg 2000;70:1792
© 2000 The Society of Thoracic Surgeons

---

Scientific abstract

Analysis of neuropsychological deficits 6 months after hypothermic and normothermic coronary artery bypass surgery

Cardiac Surgical Research Group and Health Psychology, Flinders Medical Centre, Adelaide, Australia

Introduction. Although normothermic bypass has been espoused as an efficacious method of myocardial protection during coronary artery bypass surgery (CABG), debate still surrounds the impact on postoperative neuropsychological (NP) functioning.

Methods. After institutional approval and informed consent, patients were randomized to receive either normothermic (systemic normothermia and intermittent warm [37°C] blood cardioplegia; n=65) or hypothermic (systemic hypothermia [30 to 32°C] and intermittent cold blood cardioplegia [8 to 10°C]; n=58) CABG surgery. NP assessments were performed preoperatively (T1), 7 days (T2), and 6 months postoperatively (T3). Reliable change indices were used to calculate incidence of NP deficits.

Results. At both T2 and T3, the groups did not differ on the incidence of NP deficits on each measure, or on the number of tests per patient showing a deficit. On the majority of NP measures, there was a reduction in the incidence of deficits from T2 to T3. For hypothermics, this reduction was significant for CVLT total (13.8% vs 6.5%) and Peg R (14.0% vs 2.2%). For normothermics, the reduction was significant for CVLT total (19.7% vs 4.1%), CVLT long cued (10.8% vs 0%), Peg R (14.1% vs 0%), and Dig Symb (23.1% vs 4.2%). For the normothermic group, there was a significant reduction from T2 to T3 in the number of tests per patient showing a decline (p=0.042). There was no difference between the two groups on a combined clinical endpoint of intensive care unit hours >48, length of stay >10 days, and 30-day mortality.

Conclusions. Normothermic bypass provides cerebral protection comparable with hypothermic bypass.

Issues. Reliable change indices; normothermic versus hypothermic bypass.