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

This Article Full Text 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 Search for Related Content Related Collections Related Article

J Thorac Cardiovasc Surg 2007;134:1451-1452
© 2007 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

Discussion

Dr J. Hammon (Winston-Salem, NC): I congratulate Dr Boodhwani and his coworkers on an excellent randomized prospective study, and thanks again for sending me the article and the slides in advance. Our group and others have admired the work of Dr Nathan and people like yourself who have done careful randomized studies evaluating hypothermia as a neuroprotective adjunct to surgery. The previous article that you referred to was what I would call a landmark study in that as a result of your publication, many groups, including ours, stopped doing active rewarming in the operating room, and I noticed you say in your article that this work served to validate that study.

In terms of the hypothesis that you gave at the beginning of your presentation, you stated that you wanted to validate the study and to actually examine the effects of hypothermia without the effects of rewarming. Tell me how you arrived at this and why you used the water jacket on the hypothermic patients, given that the pump temperature was exactly the same as the temperature that you were aiming for (34.5°C) and should have maintained the brain at that temperature?

Dr Boodhwani: Thank you for your positive comments. First of all, the reason for the confirmatory study was the fact that the first study was confounded by the effect of rewarming. Although hyperthermia was avoided in both studies, it was impossible in the first study to separate the potential harmful effect of rewarming in the normothermic group from the potential beneficial effect of hypothermia in the hypothermic group, and therefore we wanted to conduct a study in which pure hypothermia was the only intervention. The best way to achieve that without relying on the CPB machine, for which you would have to first cannulate the aorta and . . . [Full Text of this Article]

Related Article

Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery: A randomized, double-blind study

Munir Boodhwani, Fraser Rubens, Denise Wozny, Rosendo Rodriguez, and Howard J. Nathan
J. Thorac. Cardiovasc. Surg. 2007 134: 1443-1452. [Abstract] [Full Text] [PDF]