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J Thorac Cardiovasc Surg 2001;121:597
© 2001 The American Association for Thoracic Surgery

Letters to the Editor

pH-stat strategy and hypothermia of 25°C alone should protect the central nervous system consistently from 75 minutes of circulatory arrest

Tadaomi-Alfonso Miyamoto, MD a, Koho-Julio Miyamoto, MD, PhD b

aResearch Department
Kokura Memorial Hospital
1-1 Kifune-cho
Kokura-kitaku
Kitakyushu-shi 802-8555, Japan

bAssistant Professor II
Department of Physiology
The University of Ryukyus School of Medicine
Okinawa, Japan

To the Editor:

We do not doubt the protective effects of Na+ channel blockade, but Anttila and associatesGo 1 have failed to interpret their own data, despite having made the statistical analysis and found significant changes. Discussing significant findings is the least we can ask even if the interpretation reached may not be agreeable to everybody. Failing to discuss findings is worse than jumping to conclusions without analyzing statistically. We will not repeat here their two grave omissions.

Had they properly interpreted their findings, they should have reached the conclusion that something was wrong in the induction of hypothermia itself besides the protective effects of lamotrigine. We believe the effects of proper pH management are far greater than those provided by lamotrigine, riluzole, or memantine, and pH-stat strategies should be re-appraised with modern technology based on actual experimentation and not computer simulations, as advocated by some groups.

12/8/113014

doi:10.1067/mtc.2001.113014

References

  1. Anttila V, Rimpiläinen J, Pokela M, Kiviluoma K, Mäkiranta M, Jäntti V, et al. Lamotrigine improves cerebral outcome after hypothermic circulatory arrest: a study in a chronic porcine model. J Thorac Cardiovasc Surg 2000;120:247-55.[Abstract/Free Full Text]




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