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A vulnerable interval for cerebral injury—comparison of hypothermic circulatory arrest and low flow cardiopulmonary bypass

Published online by Cambridge University Press:  19 August 2008

Craig K. Mezrow ,
Peter S. Midulla ,
Ali M. Sadeghi ,
Otto Dapunt ,
Alejandro Gandsas ,
Howard Shiang ,
David A. D'Alessandro  and
Randall B. Griepp
Craig K. Mezrow*
Affiliation:
From the Mount Sinai Medical Center, New York
Peter S. Midulla
Affiliation:
From the Mount Sinai Medical Center, New York
Ali M. Sadeghi
Affiliation:
From the Mount Sinai Medical Center, New York
Otto Dapunt
Affiliation:
From the Mount Sinai Medical Center, New York
Alejandro Gandsas
Affiliation:
From the Mount Sinai Medical Center, New York
Howard Shiang
Affiliation:
From the Mount Sinai Medical Center, New York
David A. D'Alessandro
Affiliation:
From the Mount Sinai Medical Center, New York
Randall B. Griepp
Affiliation:
From the Mount Sinai Medical Center, New York
*
Mr. Craig Mezrow, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, P.O. Box 1028, One Gustave L. Levy Place, New York, NY 10029, USA. Tel. (212) 241-4125; Fax. (212) 534-3357.
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Extract

Over the past two decades, advances in equipment used for cardiopulmonary bypass and in operative techniques have resulted in a tremendous decrease in the mortality of patients undergoing surgical repair of congenital heart disease utilizing hypothermic circulatory arrest. Despite the widespread use of hypothermic arrest, opinion is not unanimous with regard to its safety. Previous studies which have examined neurological outcome following repair of congenital heart disease in infancy have generally agreed that when the period of arrest exceeds 60 minutes, there is increasing risk of cerebral injury.

Keywords

Cerebral metabolismhypothermic circulatory arrestlow flow bypass
Type
World Forum for Pediatric Cardiology Symposium on Cardiopulmonary Bypass (Part 1)
Information
Cardiology in the Young , Volume 3 , Issue 3 , July 1993 , pp. 287 - 298
Copyright
Copyright © Cambridge University Press 1993

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References

1.Blackwood, MJA, Haka-Ikse, K, Steward, DJ. Developmental outcome in children undergoing surgery with profound hypo thermia. Anesthesiology 1986; 65: 437–440.CrossRefGoogle Scholar
2.Clarkson, PM, MacArthur, BA, Barratt-Boyes, BG, Whitlock, RM, Neutze, JM. Developmental progress after cardiac surgeiy in infancy using hypothermia and circulatoiy arrest. Circulation 1980; 62: 855–861.CrossRefGoogle Scholar
3.Cohen, ME, Olszowka, JS, Subramanian, S.Electroencephalographic and neurological correlates of deep hypothermia and circulatory arrest in infants. Ann Thorac Surg 1976; 23: 238–244.CrossRefGoogle Scholar
4.Ehyai, A, Fenichel, GM, Bender, HW. Incidence and prognosis of seizures in infants after cardiac surgery with profound hypothermia and circulatory arrest. J Am Med Assoc 1984; 252: 3165–3176.CrossRefGoogle ScholarPubMed
5.Greeley, WJ, Kern, FH, Ungerleider, RM, Boyd, JL, Quill, T, Smith, RL, Baldwin, B, Reves, JG. The effect of hypothermic cardiopulmonary bypass and total circulatory arrest on cere bral metabolism in neonates, infants, and children. J Thorac Cardiovasc Surg 1991; 101: 783–94.Google Scholar
6.Swain, JA, McDonald, TJ, Griffith, PK, Balaban, RS, Clark, RE, Ceckler, T. Low-flow hypothermic cardiopulmonary bypass protects the brain. J Thorac Cardiovasc Surg 1991; 102: 76–84.Google Scholar
7.Mezrow, CK, Sadeghi, AM, Gandsas, A, Dapunt, O, Shiang, H, Zappulla, R, Griepp, RB.Cerebral blood flow and metabolism:Comparison of low flow cardiopulmonary bypass and hypo therrnic circulatory arrest.Ann Thorac Surg. [In press]Google Scholar
8.Mezrow, CK, Midulla, P.Sadeghi, AM, Gandsas, A, Zappulla, R, Griepp, RB. Evaluation of cerebral metabolism and quantita tive FEG following hypothermic circulatory arrest and low flow cardiopulmonary bypass at different temperatures. J Thorac Cardiovasc Surg 1993. [In press]Google Scholar
9.Rudolph, AM, Heymann, MA. The circulation of the fetus inutero: methods for studying distribution ofblood flow, cardiac output and organ blood flow. Circulation Res 1967; 21: 163–184.CrossRefGoogle Scholar