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Cerebral dysfunction after coronary artery bypass grafting done with mild or moderate hypothermia
E J Heyer1, D C Adams, E Delphin
1Department of Anesthesiology, Columbia University, New York, NY 10032-3784, USA.
Insights
Mild or moderate hypothermia during cardiopulmonary bypass for coronary artery bypass grafting showed no difference in postoperative cerebral dysfunction. Both mild hypothermia and moderate hypothermia are safe for brain function in these patients.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Anesthesiology
Background:
- Coronary artery bypass grafting (CABG) is a common surgical procedure.
- Cardiopulmonary bypass (CPB) is frequently used during CABG.
- Cerebral dysfunction is a potential complication after CPB.
Purpose of the Study:
- To compare the incidence of cerebral dysfunction after "mild" versus "moderate" hypothermia during CPB in patients undergoing elective CABG.
- To evaluate the impact of different hypothermia levels on neurological and neuropsychometric outcomes.
Main Methods:
- Prospective, randomized study of 99 patients undergoing elective CABG.
- Patients were assigned to either mild or moderate hypothermia during CPB.
- Neurologic examinations and neuropsychometric tests were performed pre- and post-operatively, with some patients followed up at 6 weeks.
Main Results:
- No statistically significant difference in the incidence of new primitive reflexes between the mild and moderate hypothermia groups.
- Neuropsychometric performances were statistically similar between the two groups.
- Both mild and moderate hypothermia appear to have comparable safety profiles regarding cerebral dysfunction.
Conclusions:
- There is no detectable difference in postoperative cerebral dysfunction between mild and moderate hypothermia during CPB in CABG patients.
- The choice between mild and moderate hypothermia does not appear to influence the risk of cerebral complications.
- These findings suggest that both hypothermia strategies are equally safe for brain protection during CABG.
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.