Developmental and neurologic effects of alpha-stat versus pH-stat strategies for deep hypothermic cardiopulmonary bypass in infants
Open accessAbstract
Objectives In a randomized single-center trial, we compared developmental and neurologic outcomes at 1 and 2 to 4 years of age in children who underwent reparative cardiac operations at less than 9 months of age after use of the alpha-stat versus pH-stat strategy during deep hypothermic cardiopulmonary bypass.Methods Among 168 children eligible for follow-up, 1-year developmental evaluations were carried out on 111, neurologic evaluations on 110, and electroencephalographic evaluations on 102. Parents of 122 children completed questionnaires on behavior and development when children were 2 to 4 years of age.Results The Psychomotor Development Index scores of the alpha-stat and pH-stat groups did not differ significantly (P =.97). For Mental Development Index scores, the treatment group effect differed according to diagnosis (P =.007). In the D -transposition of the great arteries (n = 59) and tetralogy of Fallot (n = 36) subgroups, the pH-stat group had slightly higher Mental Development Index scores than the alpha-stat group, although these differences were not statistically significant. In the ventricular septal defect subgroup (n = 16), the alpha-stat group had significantly higher scores. Psychomotor Development Index and Mental Development Index scores were significantly higher in the group with D -transposition of the great arteries than in the other 2 groups (P =.03 and P =.01, respectively). Across all diagnoses, Mental Development Index scores were significantly higher than Psychomotor Development Index scores (P <.001). Treatment group assignment was not significantly associated with abnormalities on neurologic examination (P =.70) or electroencephalographic examination (P =.77) at 1 year or with parents' ratings of children's development (P =.99) or behavior (P =.27) at age 2 to 4 years.Conclusions Use of alpha-stat versus pH-stat acid-base management strategy during reparative infant cardiac operations with deep hypothermic cardiopulmonary bypass was not consistently related to either improved or impaired early neurodevelopmental outcomes.
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References 25 · Cited by 199
Research works printed but not linked: 2
- [12]12. O'Doherty N. Neurological exam of the newborn: a routine for all. Boston: MTP Press; 1986.
- [17]17. Dunn L, Dunn L. The peabody picture vocabulary test: manual for forms L and M. Revised edition. Circle Pines (MN):American Guidance Service; 1981.
- Authors
- Bellinger, D. C., Wypij, D., du Plessis, A. J., Rappaport, L. A., Riviello, J., Jonas, R. A., & Newburger, J. W.
- Affiliations
- Boston Children's Hospital (US)
- Harvard University (US)
- Venue
- The Journal of Thoracic and Cardiovascular Surgery
- Publisher
- Elsevier BV
- Published
- 2001-02
- Volume
- 121
- Issue
- 2
- Pages
- 374-383
- ISSN
- 0022-5223 (ISSN-L)
- OpenAlex
- W1978130389
- Cited by
- 199
- References
- 25
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 9 · 2018: 5 · 2017: 3 · 2016: 9 · 2015: 8 · 2014: 6 · 2013: 5 · 2012: 5
- FWCI
- 10.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl041786-13)
- National Heart, Lung, and Blood Institute (HL 41786)
- National Center for Research Resources (M01RR002172, RR02172)
- Topics
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Keywords
- alpha-stat, pH-stat, infants, neurodevelopmental outcomes, acid-base management, congenital heart surgery, d-transposition of the great arteries, tetralogy of Fallot, ventricular septal defect, EEG, cognitive development, psychomotor development, neurological outcome
- MeSH terms
- Body Temperature, Carbon Dioxide, Child Behavior, Child Development, Developmental Disabilities, Child, Preschool, Electroencephalography, Female, Follow-Up Studies, Heart Septal Defects, Ventricular, Humans, Hydrogen-Ion Concentration, Hypothermia, Induced, Infant, Male, Neurologic Examination, Prospective Studies, Tetralogy of Fallot, Transposition of Great Vessels
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