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Neuropsychologic outcome after deep hypothermic circulatory arrest in adults
Open accessAbstract
INTRODUCTION: Pediatric patients undergoing prolonged periods of deep hypothermic circulatory arrest have been found to experience long-term deficits in cognitive function. However, there is limited information of this type in adult patients who are undergoing deep hypothermic circulatory arrest for thoracic aortic repairs. METHODS: One hundred forty-nine patients undergoing elective cardiac or thoracic aortic operations were evaluated preoperatively; 106 patients were evaluated early in the postoperative period (EARLY), and 77 patients were evaluated late in the postoperative period (LATE) with a battery of neuropsychologic tests. Seventy-three patients had routine cardiac operations without deep hypothermic circulatory arrest, and 76 patients with deep hypothermic circulatory arrest were divided into 2 subgroups: those with 1 to 24 minutes of deep hypothermic circulatory arrest (n = 36 patients) and those with 25 minutes or more of deep hypothermic circulatory arrest (n = 40 patients). The neuropsychologic test battery consisted of 8 tests encompassing 5 domains: attention, processing speed, memory, executive function, and fine motor function. Data were normalized to baseline values, and changes from baseline were analyzed by analysis of covariance, multivariate logistic regression, and survival functions. RESULTS: In all domains, poor performance or inability to be tested EARLY were significant predictors of poor performance LATE (odds ratio, 5.27; P <.01). Deep hypothermic circulatory arrest of 25 minutes or more and advanced age were significant predictors of poor performance LATE for the memory and fine motor domains. Deep hypothermic circulatory arrest of 25 minutes or more (odds ratio, 4. 0; P =.02) was a determinant of prolonged hospital stay (>21 days). CONCLUSION: Deep hypothermic circulatory arrest of 25 minutes or more and advanced age were associated with memory and fine motor deficits and with prolonged hospital stay.
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Cited by
Mayer, E., Jenkins, D., Lindner, J., D’Armini, A., Kloek, J., Meyns, B., Ilkjaer, L. B., Klepetko, W., Delcroix, M., Lang, I., et al. (2011) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/j.jtcvs.2010.11.024 · Cited by 733
Cerebral metabolic suppression during hypothermic circulatory arrest in humans
McCullough, J. N., Zhang, N., Reich, D. L., Juvonen, T. S., Klein, J. J., Spielvogel, D., Ergin, M. A., & Griepp, R. B. (1999) · The Annals of Thoracic Surgery · doi:10.1016/s0003-4975(99)00441-5 · Cited by 420
Self-citationBellinger, D. C., Wypij, D., du Plessis, A. J., Rappaport, L. A., Riviello, J., Jonas, R. A., & Newburger, J. W. (2001) · The Journal of Thoracic and Cardiovascular Surgery · doi:10.1067/mtc.2001.111206 · Cited by 199
Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest
Keenan, J. E., Wang, H., Ganapathi, A. M., Englum, B. R., Kale, E., Mathew, J. P., Husain, A. M., & Hughes, G. C. (2016) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2015.08.002 · Cited by 29
Metadata
- Authors
- Reich, D. L., Uysal, S., Sliwinski, M., Ergin, M. A., Kahn, R. A., Konstadt, S. N., McCullough, J., Hibbard, M. R., Gordon, W. A., & Griepp, R. B.
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 1999-01
- Volume
- 117
- Issue
- 1
- Pages
- 156-163
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W2157052004
- Cited by
- 202
- References
- 0
- FWCI
- 7.46
- Type
- journal article
- Language
- en
- Open access
- hybrid
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- Reich, D. L., Uysal, S., Sliwinski, M., Ergin, M. A., Kahn, R. A., Konstadt, S. N., McCullough, J., Hibbard, M. R., Gordon, W. A., & Griepp, R. B. (1999). Neuropsychologic outcome after deep hypothermic circulatory arrest in adults. The Journal of Thoracic and Cardiovascular Surgery. https://doi.org/10.1016/s0022-5223(99)70481-2
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