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J Thorac Cardiovasc Surg 1997;114:270-277
© 1997 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

CEREBRAL DYSFUNCTION AFTER CORONARY ARTERY BYPASS GRAFTING DONE WITH MILD OR MODERATE HYPOTHERMIA

Supported in part by a grant-in-aid award to Dr. Heyer from the American Heart Association, New York City Affiliate; by a grant to Dr. Adams from the CPMC Office of Clinical Trials, New York, N.Y.; and by grant 5 MO1 RR00645 to Dr. McMahon from the National Institutes of Health, Division of Research Resources, General Clinical Research Centers Program. Dr. Heyer is a Herbert Irving Assistant Professor of Anesthesiology. Dr. Oz is a Herbert Irving Assistant Professor of Surgery.

Received for publication May 23, 1996 Revisions requested Dec. 26, 1996; revisions received Jan. 20, 1997 Accepted for publication Feb. 21, 1997. Address for reprints: Eric J. Heyer, MD, PhD, Department of Anesthesiology, Columbia University, PH 5-535, 630 West 168th St., New York, NY 10032-3784.

Abstract

Objective: Ninety-nine patients undergoing elective coronary artery bypass grafting were enrolled in a prospective, randomized study to evaluate the incidence of cerebral dysfunction after "mild" or "moderate" hypothermia during cardiopulmonary bypass. Methods: Patients were evaluated before and after operation before hospital discharge and in some cases at follow-up at least 6 weeks later with a complete neurologic examination (85 patients) and a battery of standard neuropsychometric tests (86 patients). Results: Postoperative changes detected by neurologic examination consisted of the appearance of new primitive reflexes in both groups. No statistically significant differences in incidence were found. The neuropsychometric performances of the two groups were statistically similar by either event-rate or group-rate analysis. Conclusions: There is no detectable difference in postoperative cerebral dysfunction in patients undergoing coronary artery bypass grafting who are supported by cardiopulmonary bypass with either mild or moderate hypothermia. J Thorac Cardiovasc Surg 1997;114:270-7

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