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Ann Thorac Surg 2000;69:313
© 2000 The Society of Thoracic Surgeons

Correspondence

Reply

William A. Baumgartner, MDa, Elaine E. Tseng, MDa

a Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, MD 21287, USA

e-mail: wbaumgar{at}csurg.jhmi.jhu.edu

To the Editor

We appreciate very much the comments of Drs Tadaomi-A. Miyamoto and Koho-J Miyamoto from Kokura Memorial Hospital and the University of the Ryukius, respectively. They have raised a very interesting point to our experiments involving hypothermic circulatory arrest. Their letter and support of evidence would suggest that pH-stat management during hypothermic circulatory arrest would enhance cerebral recovery in this canine model.

We agree with them that there are certainly many factors that contribute to neurologic injury after both routine cardiopulmo-nary bypass as well as adjunctive hypothermic circulatory arrest. These include acidosis, hemoglobin changes, and reduced glucose. For these reasons, all of our experimental studies (both control and interventional) are conducted so that hemoglobin, glucose, and pH are maintained at similar levels throughout the experiments.

We very much appreciate their comments and in the future will address the issue of pH-stat management and its effect on cerebral function after hypothermic circulatory arrest. As they point out, we have a very stable model that can be used to further elucidate the mechanism of neurologic injury and those interventions that may be beneficial to overall cerebral recovery.





This Article
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Elaine E. Tseng
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