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

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

J Thorac Cardiovasc Surg 1995;110:349-362
© 1995 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

A RANDOMIZED STUDY OF THE INFLUENCE OF PERFUSION TECHNIQUE AND pH MANAGEMENT STRATEGY IN 316 PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY:II. Neurologic and cognitive outcomes

London and Ottawa, Ontario, and Vancouver, British Columbia, Canada

Supported by grant A1498 from the Heart and Stroke Foundation of Ontario.

Presented in part at the Fiftieth Annual Meeting of the Canadian Anaesthetists Society, Halifax, Nova Scotia, Canada, June 1993.

Received for publication Sept. 1, 1994. Accepted for publication Dec. 22, 1994. Address for reprints: John M. Murkin, MD, Department of Anaesthesia, University Hospital, 339 Windermere Road, London, Ontario, Canada N6A 5A5

Abstract

This double-blind, randomized comparison of pulsatile or nonpulsatile perfusion and alpha-stat or pH-stat management during cardiopulmonary bypass was designed to assess postoperative central nervous system outcomes. Methods: Neurologic and cognitive testing was conducted before the operation and 7 days and 2 months after the operation in 316 patients having coronary artery bypass and in a reference cohort of 40 patients having major vascular and thoracic operations. Results: As detailed in part I of this study, mortality in patients having coronary bypass was 2.8%. The incidence of stroke was 2.5% and did not differ among bypass groups. Mortality was 2.5% for the major surgery cohort. The incidence of cognitive (p = 0.003) and either neurologic or cognitive dysfunction (p = 0.0002) was higher at 7 days for the coronary bypass group than for the major surgery cohort. The incidence of neurologic dysfunction remained higher (p = 0.050) at 2 months in the coronary bypass group. Cognitive dysfunction at 2 months was less prevalent after 90 minutes of cardiopulmonary bypass in patients managed with alpha-stat than with pH-stat strategy (27% versus 44%, p = 0.047). Conclusions: Postoperative central nervous system dysfunction is more prevalent in patients having coronary bypass than in those having major operations. Pulsatility has no effect on central nervous system outcomes, but alpha-stat management is associated with a decreased incidence of cognitive dysfunction in patients undergoing prolonged cardiopulmonary bypass. (J THORAC CARDIOVASC SURG 1995;110:349-62)

This article has been cited by other articles:

				D. A. Oakes and C. T. M. Mangano Cardiopulmonary Bypass in 2009: Achieving and Circulating Best Practices Anesth. Analg., May 1, 2009; 108(5): 1368 - 1370. [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. Groenendaal, K. M. K. De Vooght, and F. van Bel Blood Gas Values During Hypothermia in Asphyxiated Term Neonates Pediatrics, January 1, 2009; 123(1): 170 - 172. [Full Text] [PDF]

				K. Maekawa, T. Goto, T. Baba, A. Yoshitake, S. Morishita, and T. Koshiji Abnormalities in the Brain Before Elective Cardiac Surgery Detected by Diffusion-Weighted Magnetic Resonance Imaging Ann. Thorac. Surg., November 1, 2008; 86(5): 1563 - 1569. [Abstract] [Full Text] [PDF]

				T. C. Lisle, K. M. Barrett, L. M. Gazoni, B. R. Swenson, C. D. Scott, A. Kazemi, J. A. Kern, B. B. Peeler, I. L. Kron, and K. C. Johnston Timing of Stroke After Cardiopulmonary Bypass Determines Mortality Ann. Thorac. Surg., May 1, 2008; 85(5): 1556 - 1563. [Abstract] [Full Text] [PDF]

				P. A. Barber, S. Hach, L. J. Tippett, L. Ross, A. F. Merry, and P. Milsom Cerebral Ischemic Lesions on Diffusion-Weighted Imaging Are Associated With Neurocognitive Decline After Cardiac Surgery Stroke, May 1, 2008; 39(5): 1427 - 1433. [Abstract] [Full Text] [PDF]

				J. W. Hammon Extracorporeal Circulation: Perfusion System Card. Surg. Adult, January 1, 2008; 3(2008): 350 - 370. [Full Text]

				J. W. Hammon Extracorporeal Circulation: Organ Damage Card. Surg. Adult, January 1, 2008; 3(2008): 389 - 414. [Full Text]

				R. Pretre and M. I. Turina Deep Hypothermic Circulatory Arrest Card. Surg. Adult, January 1, 2008; 3(2008): 431 - 442. [Full Text]

				F. D. Rubens, M. Boodhwani, T. Mesana, D. Wozny, G. Wells, H. J. Nathan, and on behalf of the Cardiotomy Investigators The Cardiotomy Trial: A Randomized, Double-Blind Study to Assess the Effect of Processing of Shed Blood During Cardiopulmonary Bypass on Transfusion and Neurocognitive Function Circulation, September 11, 2007; 116(11_suppl): I-89 - I-97. [Abstract] [Full Text] [PDF]

				D. K. Harrington, F. Fragomeni, and R. S. Bonser Cerebral Perfusion Ann. Thorac. Surg., February 1, 2007; 83(2): S799 - S804. [Abstract] [Full Text] [PDF]

				J. M. Murkin, S. J. Adams, R. J. Novick, M. Quantz, D. Bainbridge, I. Iglesias, A. Cleland, B. Schaefer, B. Irwin, and S. Fox Monitoring Brain Oxygen Saturation During Coronary Bypass Surgery: A Randomized, Prospective Study Anesth. Analg., January 1, 2007; 104(1): 51 - 58. [Abstract] [Full Text] [PDF]

				T. K. Rosengart, J. J. Sweet, E. Finnin, P. Wolfe, J. Cashy, E. Hahn, J. Marymont, and T. Sanborn Stable Cognition After Coronary Artery Bypass Grafting: Comparisons With Percutaneous Intervention and Normal Controls Ann. Thorac. Surg., August 1, 2006; 82(2): 597 - 607. [Abstract] [Full Text] [PDF]

				K. G. Shann, D. S. Likosky, J. M. Murkin, R. A. Baker, Y. R. Baribeau, G. R. DeFoe, T. A. Dickinson, T. J. Gardner, H. P. Grocott, G. T. O'Connor, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: A focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 283 - 290.e3. [Full Text] [PDF]

				M. Carrier, A. Denault, J. Lavoie, and L. P. Perrault Randomized controlled trial of pericardial blood processing with a cell-saving device on neurologic markers in elderly patients undergoing coronary artery bypass graft surgery. Ann. Thorac. Surg., July 1, 2006; 82(1): 51 - 55. [Abstract] [Full Text] [PDF]

				J. M Murkin Pathophysiological Basis of CNS Injury in Cardiac Surgical Patients: Detection and Prevention Perfusion, July 1, 2006; 21(4): 203 - 208. [Abstract] [PDF]

				S. Al-Ruzzeh, S. George, M. Bustami, J. Wray, C. Ilsley, T. Athanasiou, and M. Amrani Effect of off-pump coronary artery bypass surgery on clinical, angiographic, neurocognitive, and quality of life outcomes: randomised controlled trial BMJ, June 10, 2006; 332(7554): 1365. [Abstract] [Full Text] [PDF]

				G. N. Djaiani Aortic arch atheroma: stroke reduction in cardiac surgical patients. Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2006; 10(2): 143 - 157. [Abstract] [PDF]

				C. W. Hogue Jr, T. Hershey, D. Dixon, R. Fucetola, A. Nassief, K. E. Freedland, B. Thomas, and K. Schechtman Preexisting cognitive impairment in women before cardiac surgery and its relationship with C-reactive protein concentrations. Anesth. Analg., June 1, 2006; 102(6): 1602 - 1608. [Abstract] [Full Text] [PDF]

				S. K. Bhudia, D. M. Cosgrove, R. I. Naugle, J. Rajeswaran, B.-K. Lam, E. Walton, J. Petrich, R. C. Palumbo, A. M. Gillinov, C. Apperson-Hansen, et al. Magnesium as a neuroprotectant in cardiac surgery: A randomized clinical trial J. Thorac. Cardiovasc. Surg., April 1, 2006; 131(4): 853 - 861. [Abstract] [Full Text] [PDF]

				G. M. McKhann, M. A. Grega, L. M. Borowicz Jr, W. A. Baumgartner, and O. A. Selnes Stroke and Encephalopathy After Cardiac Surgery: An Update Stroke, February 1, 2006; 37(2): 562 - 571. [Abstract] [Full Text] [PDF]

				V. I. Chernov, N. Yu. Efimova, I. Yu. Efimova, S. D. Akhmedov, and Y. B. Lishmanov Short-term and long-term cognitive function and cerebral perfusion in off-pump and on-pump coronary artery bypass patients Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 74 - 81. [Abstract] [Full Text] [PDF]

				T. K. Rosengart, J. Sweet, E. B. Finnin, P. Wolfe, J. Cashy, E. Hahn, J. Marymont, and T. Sanborn Neurocognitive Functioning in Patients Undergoing Coronary Artery Bypass Graft Surgery or Percutaneous Coronary Intervention: Evidence of Impairment Before Intervention Compared With Normal Controls Ann. Thorac. Surg., October 1, 2005; 80(4): 1327 - 1335. [Abstract] [Full Text] [PDF]

				E. Kozora, C. F. Emery, M. C. Ellison, F. S. Wamboldt, P. T. Diaz, and B. Make Improved Neurobehavioral Functioning in Emphysema Patients Following Lung Volume Reduction Surgery Compared With Medical Therapy Chest, October 1, 2005; 128(4): 2653 - 2663. [Abstract] [Full Text] [PDF]

				J. C. Halstead, D. Spielvogel, D. M. Meier, D. Weisz, C. Bodian, N. Zhang, and R. B. Griepp Optimal pH strategy for selective cerebral perfusion Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 266 - 273. [Abstract] [Full Text] [PDF]

				S. Preisman, R. Marks, O. Nahtomi-Shick, and A. Sidi Preservation of static and dynamic cerebral autoregulation after mild hypothermic cardiopulmonary bypass Br. J. Anaesth., August 1, 2005; 95(2): 207 - 211. [Abstract] [Full Text] [PDF]

				D. Bainbridge 3-D Imaging for Aortic Plaque Assessment Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2005; 9(2): 163 - 165. [Abstract] [PDF]

				E. A Black, S. Ghosh, K. Sin, T. Spyt, and R. Pillai Off-Pump Coronary Artery Bypass Surgery Asian Cardiovasc Thorac Ann, December 1, 2004; 12(4): 379 - 386. [Abstract] [Full Text] [PDF]

				S. Bar-Yosef, M. Anders, G. B. Mackensen, L. K. Ti, J. P. Mathew, B. Phillips-Bute, R. H. Messier, H. P. Grocott, and the Neurological Outcome Research Group and CARE I Aortic Atheroma Burden and Cognitive Dysfunction After Coronary Artery Bypass Graft Surgery Ann. Thorac. Surg., November 1, 2004; 78(5): 1556 - 1562. [Abstract] [Full Text] [PDF]

				J. P. Gold, K. E. Torres, W. Maldarelli, I. Zhuravlev, D. Condit, and J. Wasnick Improving Outcomes in Coronary Surgery: The Impact of Echo-Directed Aortic Cannulation and Perioperative Hemodynamic Management in 500 Patients Ann. Thorac. Surg., November 1, 2004; 78(5): 1579 - 1585. [Abstract] [Full Text] [PDF]

				K. Ohkura, T. Kazui, S. Yamamoto, K. Yamashita, H. Terada, N. Washiyama, T. Suzuki, K. Suzuki, M. Fujie, and K. Ohishi Comparison of pH management during antegrade selective cerebral perfusion in canine models with old cerebral infarction J. Thorac. Cardiovasc. Surg., September 1, 2004; 128(3): 378 - 385. [Abstract] [Full Text] [PDF]

				J. W. Hammon Risk Factors for Cardiac Surgery: The High-Risk Patient Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2004; 8(1): 15 - 17. [Abstract] [PDF]

				A. H. Menkis Management of the Ascending Aorta in Routine Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2004; 8(1): 19 - 24. [Abstract] [PDF]

				J. M. Murkin Retrograde cerebral perfusion: more risk than benefit? J. Thorac. Cardiovasc. Surg., September 1, 2003; 126(3): 631 - 633. [Full Text] [PDF]

				Z. L. Nagy, M. Collins, T. Sharpe, S. Mirsadraee, R. R. Guerrero, J. Gibbs, and K. G. Watterson Effect of Two Different Bypass Techniques on the Serum Troponin-T Levels in Newborns and Children: Does pH-Stat Provide Better Protection? Circulation, August 5, 2003; 108(5): 577 - 582. [Abstract] [Full Text] [PDF]

				O. A. Selnes, M. A. Grega, L. M. Borowicz Jr, R. M. Royall, G. M. McKhann, and W. A. Baumgartner Cognitive changes with coronary artery disease: a prospective study of coronary artery bypass graft patients and nonsurgical controls Ann. Thorac. Surg., May 1, 2003; 75(5): 1377 - 1386. [Abstract] [Full Text] [PDF]

				H. T. Kiziltan, M. Baltali, A. Bilen, G. Seydaoglu, M. Incesoz, A. Tasdelen, and S. Aslamaci Comparison of Alpha-Stat and pH-Stat Cardiopulmonary Bypass in Relation to Jugular Venous Oxygen Saturation and Cerebral Glucose-Oxygen Utilization Anesth. Analg., March 1, 2003; 96(3): 644 - 650. [Abstract] [Full Text] [PDF]

				J. Vaage and R. Anderson Biochemical markers of neurologic injury in cardiac surgery: The rise and fall of S100{beta} J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(90030): S31 - 33. [Full Text] [PDF]

				E. A. Hessel II and L. H. Edmunds Jr. Extracorporeal Circulation: Perfusion Systems Card. Surg. Adult, January 1, 2003; 2(2003): 317 - 338. [Full Text]

				J. W. Hammon Jr. and L. H. Edmunds Jr. Extracorporeal Circulation: Organ Damage Card. Surg. Adult, January 1, 2003; 2(2003): 361 - 388. [Full Text]

				R. Pretre and M. I. Turina Deep Hypothermic Circulatory Arrest Card. Surg. Adult, January 1, 2003; 2(2003): 401 - 412. [Full Text]

				T. W. Willcox and R. van Uden Best Practice for Cardiopulmonary Bypass in the High-Risk Elderly Patient Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2002; 6(4): 293 - 300. [Abstract] [PDF]

				C. Bartels, A. Gerdes, J. Babin-Ebell, F. Beyersdorf, U. Boeken, T. Doenst, P. Feindt, M. Heiermann, C. Schlensak, and H.-H. Sievers Cardiopulmonary bypass: Evidence or experience based? J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 20 - 27. [Abstract] [Full Text] [PDF]

				F. M. Fouad-Tarazi, J. Feldschuh, S. M. F. Malheiros, A. R. Massaro, E. Buffolo, D. Venes, W. T. C. Yuh, C. J. Knott-Craig, M. D. Tilak, D. van Dijk, et al. Cognitive Outcomes Following Cardiopulmonary Bypass JAMA, June 19, 2002; 287(23): 3077 - 3079. [Full Text] [PDF]

				D. Van Dijk, E. W. L. Jansen, R. Hijman, A. P. Nierich, J. C. Diephuis, K. G. M. Moons, J. R. Lahpor, C. Borst, A. M. A. Keizer, H. M. Nathoe, et al. Cognitive Outcome After Off-Pump and On-Pump Coronary Artery Bypass Graft Surgery: A Randomized Trial JAMA, March 20, 2002; 287(11): 1405 - 1412. [Abstract] [Full Text] [PDF]

				J. M. Murkin, W. D. Boyd, S. Ganapathy, S. J. Adams, R. C. Peterson, J. Morgan, and P. Lok Neuroprotection During CPB: From Mechanisms to Interventions Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2002; 6(1): 3 - 6. [Abstract] [PDF]

				J. M. Murkin Neurologic Monitoring During Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2002; 6(1): 35 - 38. [Abstract] [PDF]

				A. M. Grigore, H. P. Grocott, J. P. Mathew, B. Phillips-Bute, T. O. Stanley, A. Butler, K. P. Landolfo, J. G. Reves, J. A. Blumenthal, and M. F. Newman The Rewarming Rate and Increased Peak Temperature Alter Neurocognitive Outcome After Cardiac Surgery Anesth. Analg., January 1, 2002; 94(1): 4 - 10. [Abstract] [Full Text] [PDF]

				R. P. Alston, K. Yoshitani, M. Kawaguch, H. Furuya, and N. Kurumatani Cerebral Oxygenation and Cognitive Decline Anesth. Analg., December 1, 2001; 93(6): 1628 - 1628. [Full Text] [PDF]

				J. M. Murkin Adverse Central Nervous System Outcomes After Cardiopulmonary Bypass: A Beneficial Effect of Aprotinin? Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 282 - 285. [Abstract] [PDF]

				W. A. L. Soong, S. Uysal, and D. L. Reich Cerebral Protection During Surgery of the Aortic Arch Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 286 - 292. [Abstract] [PDF]

				J. Vaage and R. Anderson Biochemical markers of neurologic injury in cardiac surgery: The rise and fall of S100{beta} J. Thorac. Cardiovasc. Surg., November 1, 2001; 122(5): 853 - 855. [Full Text] [PDF]

				J. M. Murkin Attenuation of neurologic injury during cardiac surgery Ann. Thorac. Surg., November 1, 2001; 72(5): S1838 - 1844. [Abstract] [Full Text] [PDF]

				M. J. A. Robson, R. P. Alston, I. J. Deary, P. J. D. Andrews, and M. J. Souter Jugular Bulb Oxyhemoglobin Desaturation, S100{beta}, and Neurologic and Cognitive Outcomes After Coronary Artery Surgery Anesth. Analg., October 1, 2001; 93(4): 839 - 845. [Abstract] [Full Text] [PDF]

				S. J. Fearn, R. Pole, K. Wesnes, E. B. Faragher, T. L. Hooper, and C. N. McCollum Cerebral injury during cardiopulmonary bypass: Emboli impair memory J. Thorac. Cardiovasc. Surg., June 1, 2001; 121(6): 1150 - 1160. [Abstract] [Full Text] [PDF]

				K. Yoshitani, M. Kawaguchi, N. Sugiyama, M. Sugiyama, S. Inoue, T. Sakamoto, K. Kitaguchi, and H. Furuya The Association of High Jugular Bulb Venous Oxygen Saturation with Cognitive Decline After Hypothermic Cardiopulmonary Bypass Anesth. Analg., June 1, 2001; 92(6): 1370 - 1376. [Abstract] [Full Text] [PDF]

				R. E. Anderson, L.-O. Hansson, O. Nilsson, J. Liska, G. Settergren, and J. Vaage Increase in serum S100A1-B and S100BB during cardiac surgery arises from extracerebral sources Ann. Thorac. Surg., May 1, 2001; 71(5): 1512 - 1517. [Abstract] [Full Text] [PDF]

				M. A. Borger, C. M. Peniston, R. D. Weisel, M. Vasiliou, R. E. A. Green, and C. M. Feindel Neuropsychologic impairment after coronary bypass surgery: Effect of gaseous microemboli during perfusionist interventions J. Thorac. Cardiovasc. Surg., April 1, 2001; 121(4): 743 - 749. [Abstract] [Full Text] [PDF]

				M. A. Priestley, J. A. Golden, I. B. O'Hara, J. McCann, and C. D. Kurth Comparison of neurologic outcome after deep hypothermic circulatory arrest with alpha-stat and pH-stat cardiopulmonary bypass in newborn pigs J. Thorac. Cardiovasc. Surg., February 1, 2001; 121(2): 0336 - 343. [Abstract] [Full Text] [PDF]

				D. C. Bellinger, D. Wypij, A. J. du Plessis, L. A. Rappaport, J. Riviello, R. A. Jonas, and J. W. Newburger Developmental and neurologic effects of alpha-stat versus pH-stat strategies for deep hypothermic cardiopulmonary bypass in infants J. Thorac. Cardiovasc. Surg., February 1, 2001; 121(2): 0374 - 383. [Abstract] [Full Text] [PDF]

				M. Czerny, H. Baumer, J. Kilo, A. Zuckermann, G. Grubhofer, O. Chevtchik, E. Wolner, and M. Grimm Complete revascularization in coronary artery bypass grafting with and without cardiopulmonary bypass Ann. Thorac. Surg., January 1, 2001; 71(1): 165 - 169. [Abstract] [Full Text] [PDF]

				M. J. A. Robson, R. P. Alston, I. J. Deary, P. J. D. Andrews, M. J. Souter, and S. Yates Cognition After Coronary Artery Surgery Is Not Related to Postoperative Jugular Bulb Oxyhemoglobin Desaturation Anesth. Analg., December 1, 2000; 91(6): 1317 - 1326. [Abstract] [Full Text] [PDF]

				D. van Dijk, A. M. A. Keizer, J. C. Diephuis, C. Durand, L. J. Vos, and R. Hijman Neurocognitive dysfunction after coronary artery bypass surgery: A systematic review J. Thorac. Cardiovasc. Surg., October 1, 2000; 120(4): 632 - 639. [Abstract] [Full Text] [PDF]

				M. Grimm, M. Czerny, H. Baumer, J. Kilo, C. Madl, L. Kramer, A. Rajek, and E. Wolner Normothermic cardiopulmonary bypass is beneficial for cognitive brain function after coronary artery bypass grafting - a prospective randomized trial Eur. J. Cardiothorac. Surg., September 1, 2000; 18(3): 270 - 275. [Abstract] [Full Text] [PDF]

				M. F. Newman, T. O. Stanley, and H. P. Grocott Strategies to Protect the Brain During Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 2000; 4(2): 53 - 64. [Abstract] [PDF]

				J. M. Murkin Central Nervous System Complications in Cardiac Surgery: Retrograde Cerebral Perfusion, Pressure, Pulsatility, Temperature, and pH Management During Cardiopulmonary Bypass Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 2000; 4(2): 65 - 69. [Abstract] [PDF]

				T. Goto, T. Baba, A. Yoshitake, Y. Shibata, M. Ura, and R. Sakata Craniocervical and aortic atherosclerosis as neurologic risk factors in coronary surgery Ann. Thorac. Surg., March 1, 2000; 69(3): 834 - 840. [Abstract] [Full Text] [PDF]

				R. E. Anderson, L.-O. Hansson, J. Liska, G. Settergren, and J. Vaage The effect of cardiotomy suction on the brain injury marker S100{beta} after cardiopulmonary bypass Ann. Thorac. Surg., March 1, 2000; 69(3): 847 - 850. [Abstract] [Full Text] [PDF]

				W. A. C. Mutch, R. K. Warrian, G. M. Eschun, L. G. Girling, L. Doiron, M. S. Cheang, and G. R. Lefevre Biologically variable pulsation improves jugular venous oxygen saturation during rewarming Ann. Thorac. Surg., February 1, 2000; 69(2): 491 - 497. [Abstract] [Full Text] [PDF]

				S NEWMAN and J STYGALL Changes in cognition following cardiac surgery Heart, November 1, 1999; 82(5): 541 - 542. [Full Text]

				K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]

				J. M. Murkin, W. D. Boyd, S. Ganapathy, S. J. Adams, and R. C. Peterson Beating heart surgery: why expect less central nervous system morbidity? Ann. Thorac. Surg., October 1, 1999; 68(4): 1498 - 1501. [Abstract] [Full Text] [PDF]

				Y. Kadoi, F. Kawahara, S. Saito, T. Morita, F. Kunimoto, F. Goto, and N. Fujita Effects of hypothermic and normothermic cardiopulmonary bypass on brain oxygenation Ann. Thorac. Surg., July 1, 1999; 68(1): 34 - 39. [Abstract] [Full Text] [PDF]

				O. A. Selnes, M. A. Goldsborough, L. M. Borowicz Jr, C. Enger, S. A. Quaskey, and G. M. McKhann Determinants of cognitive change after coronary artery bypass surgery: a multifactorial problem Ann. Thorac. Surg., June 1, 1999; 67(6): 1669 - 1676. [Abstract] [Full Text] [PDF]

				R. E. Anderson, L.-O. Hansson, and J. Vaage Release of S100B during coronary artery bypass grafting is reduced by off-pump surgery Ann. Thorac. Surg., June 1, 1999; 67(6): 1721 - 1725. [Abstract] [Full Text] [PDF]

				J. M. Murkin Strategies and Techniques for Neuroprotection in Coronary Artery Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 4 - 8. [Abstract] [PDF]

				C. W. Hogue JR, B. Barzilai, and V. G. Davila-Roman Stroke Reduction: Diagnosis and Management of the Atherosclerotic Ascending Aorta During Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 17 - 24. [Abstract] [PDF]

				G. M. McKhann, M. A. Goldsborough, L. M. Borowicz JR, C. Enger, S. Quaskey, and O. A. Selnes Neurobehavioral Outcomes of Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 25 - 29. [Abstract] [PDF]

				M. F. Newman, D. T. Laskowitz, A. M. Saunders, A. M. Grigore, and H. P. Grocott Genetic Predictors of Perioperative Neurologic and Neuropsychological Injury and Recovery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 34 - 46. [Abstract] [PDF]

				D. A. Stump, W. R. Brown, D. M. Moody, K. D. Rorie, J. C. Manuel, N. D. Kon, J. B. Butterworth, and J. W. Hammon Microemboli and Neurologic Dysfunction After Cardiovascular Surgery Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1999; 3(1): 47 - 54. [Abstract] [PDF]

				R. A Jonas Optimal pH strategy for cardiopulmonary bypass in neonates, infants and children Perfusion, December 1, 1998; 13(6): 377 - 387. [PDF]

				A. J. du Plessis, R. A. Jonas, D. Wypij, P. R. Hickey, J. Riviello, D. L. Wessel, S. J. Roth, F. A. Burrows, G. Walter, D. M. Farrell, et al. PERIOPERATIVE EFFECTS OF ALPHA-STAT VERSUS pH-STAT STRATEGIES FOR DEEP HYPOTHERMIC CARDIOPULMONARY BYPASS IN INFANTS J. Thorac. Cardiovasc. Surg., December 1, 1997; 114(6): 991 - 1001. [Abstract] [Full Text]

				E. J. Heyer, D. C. Adams, E. Delphin, D. J. McMahon, S. D. Steneck, M. C. Oz, R. E. Michler, and E. A. Rose CEREBRAL DYSFUNCTION AFTER CORONARY ARTERY BYPASS GRAFTING DONE WITH MILD OR MODERATE HYPOTHERMIA J. Thorac. Cardiovasc. Surg., August 1, 1997; 114(2): 270 - 277. [Abstract] [Full Text]

				A. J. du Plessis Topical Review: Cerebral Hemodynamics and Metabolism During Infant Cardiac Surgery. Mechanisms of Injury and Strategies for Protection J Child Neurol, August 1, 1997; 12(5): 285 - 300. [Abstract] [PDF]

				J. W. Hammon Jr, D. A. Stump, N. D. Kon, A. R. Cordell, A. S. Hudspeth, T. E. Oaks, R. F. Brooker, A. T. Rogers, R. Hilbawi, L. H. Coker, et al. Risk Factors and Solutions for the Development of Neurobehavioral Changes After Coronary Artery Bypass Grafting Ann. Thorac. Surg., June 1, 1997; 63(6): 1613 - 1617. [Abstract] [Full Text]

				J. M. Murkin Alpha-stat acid-base regulation during cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 619 - 619. [Full Text]

				D. J. Chambers Alpha-stat acid-base regulation during cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., March 1, 1997; 113(3): 619 - 620. [Full Text]

				J. M. Murkin, J. S. Martzke, A. M. Buchan, C. Bentley, and C. J. Wong A RANDOMIZED STUDY OF THE INFLUENCE OF PERFUSION TECHNIQUE AND pH MANAGEMENT STRATEGY IN 316 PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY:I. Mortality and cardiovascular morbidity J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 340 - 348. [Abstract] [Full Text]