A Comparison of the Perioperative Neurologic Effects of Hypothermic Circulatory Arrest versus Low-Flow Cardiopulmonary Bypass in Infant Heart Surgery

New England Journal of Medicine

Volumn 329, Issue 15, 1993, Pages 1057-1064

  Newburger, Jane W ^b,c   Jonas, Richard A ^b,c   Wernovsky, Gil ^b,c   Wypij, David ^d   Hickey, Paul R ^b   Kuban, Karl ^a   Farrell, David M ^b   Holmes, Gregory L ^b,c   Helmers, Sandra L ^b,c   Constantinou, Jules ^a   Carrazana, Enrique ^b,c   Barlow, John K ^b,c   Walsh, Amy Z ^b   Lucius, Kristin C ^b,c   Share, Jane C ^b,c   Wessel, David L ^b,c   Hanley, Frank L ^b,c   Mayer, John E ^b,c   Castaneda, Aldo R ^b,c   Ware, James H ^d  

^a Children's Hospital ^*

^b BOSTON CHILDREN S HOSPITAL   (United States)

^c HARVARD MEDICAL SCHOOL   (United States)

^d HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CREATINE KINASE BB;

ARTICLE; BRAIN CIRCULATION; BRAIN INJURY; CARDIOPULMONARY BYPASS; CLINICAL FEATURE; CREATINE KINASE BLOOD LEVEL; ELECTROENCEPHALOGRAM; EPILEPTIC DISCHARGE; FOLLOW UP; HEART ARREST; HEART SURGERY; HUMAN; HYPOTHERMIA; INFANT; MAJOR CLINICAL STUDY; OPEN HEART SURGERY; PEDIATRIC SURGERY; PEROPERATIVE CARE; POSTOPERATIVE CARE; PRIORITY JOURNAL; STATISTICAL ANALYSIS;

BRAIN ISCHEMIA; CARDIOPULMONARY BYPASS; COMPARATIVE STUDY; CONFIDENCE INTERVALS; ELECTROENCEPHALOGRAPHY; EPILEPSY; HEART ARREST, INDUCED; HEART SEPTAL DEFECTS, VENTRICULAR; HUMAN; HYPOTHERMIA, INDUCED; INFANT; MONITORING, PHYSIOLOGIC; NEUROLOGIC EXAMINATION; ODDS RATIO; PROSPECTIVE STUDIES; RISK; SINGLE-BLIND METHOD; SUPPORT, U.S. GOV'T, P.H.S.; TRANSPOSITION OF GREAT VESSELS; TREATMENT OUTCOME;

EID: 0027494114     PISSN: 00284793     EISSN: 15334406     Source Type: Journal    
DOI: 10.1056/NEJM199310073291501     Document Type: Article

References (63)

1. Weiss M, Piwnica A, Lenfant C, Deep hypothermia with total circulatory arrest. Trans Am Soc Artif Intern Organs 1960; 6: 227-239
2. Kirklin JW, Dawson B, Devloo RA, Theye RA Open intracardiac operations: use of circulatory arrest during hypothermia induced by blood cooling. Ann Surg 1961; 154: 766-769
3. Barratt-Boyes BG Cardiac surgery in neonates and infants. Circulation 1971; 44: 924-925
4. Hypothermia, circulatory arrest, and cardiopulmonary bypass. In: Kirklin JW, Barratt-Boyes BG. Cardiac surgery. New York: Churchill Livingstone, 1993:62-127.
5. Rebeyka IM, Coles JG, Wilson GJ, The effect of low-flow cardiopulmonary bypass on cerebral function: an experimental and clinical study. Ann Thorac Surg 1987; 43: 391-396
6. Wilson GJ, Rebeyka IM, Coles JG, Loss of the somastosensory evoked response as an indicator of reversible cerebral ischemia during hypothermic, low-flow cardiopulmonary bypass. Ann Thorac Surg 1988; 45: 206-209
7. Swain JA, McDonald TJ Jr, Griffith PK, Balaban RS, Clark RE, Ceckler T Low-flow hypothermic cardiopulmonary bypass protects the brain. J Thorac Cardiovasc Surg 1991; 102: 76-83
8. Johnston WE, Vinten-Johansen J, DeWitt DS, O'Steen WK, Stump DA, Prough DS Cerebral perfusion during canine hypothermic cardiopulmonary bypass: effect of arterial carbon dioxide tension. Ann Thorac Surg 1991; 52: 479-489
9. Greeley WJ, Ungerleider RM Assessing the effect of cardiopulmonary bypass on the brain. Ann Thorac Surg 1991; 52: 417-419
10. Sotaniemi KA Cerebral outcome after extracorporeal circulation: comparison between prospective and retrospective evaluations. Arch Neurol 1983; 40: 75-77
11. Sotaniemi KA, Juolasmaa A, Hokkanen ET Neuropsychologic outcome after open-heart surgery. Arch Neurol 1981; 38: 2-8
12. Javid H, Tufo HM, Najafi H, Dye WS, Hunter JA, Julian OC Neurologic abnormalities following open-heart surgery. J Thorac Cardiovasc Surg 1969; 58: 502-509
13. Lee WH, Brady MP, Rowe JM, Miller WC Jr Effects of extracorporeal circulation upon behavior, personality, and brain function. II. Hemodynamic, metabolic, and psychometric correlations. Ann Surg 1971; 173: 1013-1023
14. Hammeke TA, Hastings JE Neuropsychologic alterations after cardiac operation. J Thorac Cardiovasc Surg 1988; 96: 326-331
15. Shaw PJ, Bates D, Cartlidge NE, Neurologic and neuropsychological morbidity following major surgery: comparison of coronary artery bypass and peripheral vascular surgery. Stroke 1987; 18: 700-707
16. Castaneda AR, Norwood WI, Jonas RA, Colon SD, Sanders SP, Lang P Transposition of the great arteries and intact ventricular septum: anatomical repair in the neonate. Ann Thorac Surg 1984; 38: 438-443
17. Mayer JE Jr, Jonas RA, Castaneda AR Arterial switch operation for transposition of the great arteries with intact ventricular septum. J Card Surg 1986; 1: 97-104
18. Lombroso CT Neonatal polygraphy in full-term and premature infants: a review of normal and abnormal findings. J Clin Neurophysiol 1985; 2: 105-155
19. O'Doherty N. Neurological examination of the newborn: a routine for all. Boston: MTP Press, 1986.
20. Dubowitz L, Dubowitz V. The neurological assessment of the preterm and full-term newborn infant. London: Spastics International Medical in association with Heinemann Medical, 1981.
21. Prechtl HFR. The neurological examination of the full term newborn infant: a manual for clinical use. 2nd ed. Oxford, England: Blackwell Scientific, 1977.
22. Paine RS, Oppe TE. Neurological examination of children. London: Spastics Society in association with Heinemann Medical, 1966.
23. StatXact. Statistical software for exact nonparametric inference, user manual, StatXact-Turbo. Cambridge, Mass.: CYTEL Software, 1992.
24. Berthrong M, Sabiston DC Jr Cerebral lesions in congenital heart disease: a review of autopsies on one hundred and sixty-two cases. Bull Johns Hopkins Hosp 1951; 89: 384-401
25. Tyler HR, Clark DB Incidence of neurological complications in congenital heart disease. Arch Neurol Psychiatr 1957; 77: 17-22
26. Tyler HR, Clark DB Cerebrovascular accidents in patients with congenital heart disease. Arch Neurol Psychiatr 1957; 77: 483-489
27. Phornphutkul C, Rosenthal A, Nadas AS, Berenberg W Cerebrovascular accidents in infants and children with cyanotic congenital heart disease. Am J Cardiol 1973; 32: 329-334
28. Cottrill CM, Kaplan S Cerebral vascular accidents in cyanotic congenital heart disease. Am J Dis Child 1973; 125: 484-487
29. Linderkamp O, Klose HJ, Betke K, Increased blood viscosity in patients with cyanotic congenital heart disease and iron deficiency. J Pediatr 1979; 95: 567-569
30. Terplan KL Patterns of brain damage in infants and children with congenital heart disease: association with catheterization and surgical procedures. Am J Dis Child 1973; 125: 175-185
31. Keck EW, Kimm E, Gravinghoff L, Sieg K, Lagenstein I, Kuhne D Neurologische Veranderungen und cerebrale Lasionen bei Kindern mit Transposition der grossen Arterien (TGA). Monatsschr Kinderheilkd 1981; 129: 45-47
32. Gilles FH, Leviton A, Jammes J Age-dependent changes in white matter in congenital heart disease. J Neuropathol Exp Neurol 1973; 32: 179-179 abstract.
33. Linde LM, Rasof B, Dunn OJ Mental development in congenital heart disease. J Pediatr 1967; 71: 198-203
34. Linde LM, Rasof B, Dunn OJ Longitudinal studies of intellectual and behavioral development in children with congenital heart disease. Acta Paediatr Scand 1970; 59: 169-176
35. O'Dougherty M, Wright FS, Garmezy N Later competence and adaptation in infants who survive severe heart defects. Child Dev 1983; 54: 1129-1142
36. Newburger JW, Silbert AT, Buckley LP, Fyler DC Cognitive function and age at repair of transposition of the great arteries in children. N Engl J Med 1984; 310: 1495-1499
37. Ferry PC Neurologic sequelae of open-heart surgery in children: an “irritating question.” Am J Dis Child 1990; 144: 369-373
38. Folkerth TL, Angell WW, Fosburg RG, Oury JH. Effect of deep hypothermia, limited cardiopulmonary bypass, and total arrest on growing puppies. In: Roy P-E, Rona G, eds. Recent advances in studies on cardiac structure and metabolism. Vol. 10. Baltimore: University Park Press, 1975:411-21.
39. Kramer RS, Sanders AP, Lesage AM, Woodhall B, Sealy WC The effect of profound hypothermia on preservation of cerebral ATP content during circulatory arrest. J Thorac Cardiovasc Surg 1968; 56: 699-709
40. Fisk GC, Wright JS, Turner BB, Cerebral effects of circulatory arrest at 20 °C in the infant pig. Anaesth Intensive Care 1974; 2: 33-42
41. Fisk GC, Wright JS, Hicks RG, The influence of duration of circulatory arrest at 20 °C on cerebral changes. Anaesth Intensive Care 1976; 4: 126-134
42. Wolin LR, Massopust LC Jr, White RJ Behavioral effects of autocerebral perfusion, hypothermia and arrest of cerebral blood flow in the rhesus monkey. Exp Neurol 1973; 39: 336-341
43. Treasure T, Naftel DC, Conger KA, Garcia JH, Kirklin JW, Blackstone EH The effect of hypothermic circulatory arrest time on cerebral function, morphology, and biochemistry: an experimental study. J Thorac Cardiovasc Surg 1983; 86: 761-770
44. Molina JE, Einzig S, Mastri AR, Brain damage in profound hypothermia: perfusion versus circulatory arrest. J Thorac Cardiovasc Surg 1984; 87: 596-604
45. Coles JG, Taylor MJ, Pearce JM, Cerebral monitoring of somatosensory evoked potentials during profoundly hypothermic circulatory arrest. Circulation 1984; 70: Suppl: I-96
46. Weiss M, Weiss J, Cotton J, Nicolas F, Binet JP A study of the electroencephalogram during surgery with deep hypothermia and circulatory arrest in infants. J Thorac Cardiovasc Surg 1975; 70: 316-329
47. Rossi R, Ekroth R, Lincoln C, Detection of cerebral injury after total circulatory arrest and profound hypothermia by estimation of specific creatine kinase isoenzyme levels using monoclonal antibody techniques. Am J Cardiol 1986; 58: 1236-1241 [Erratum, J Cardiol 1987;59:A12.]
48. Fox LS, Blackstone EH, Kirklin JW, Stewart RW, Samuelson PN Relationship of whole body oxygen consumption to perfusion flow rate during hypothermic cardiopulmonary bypass. J Thorac Cardiovasc Surg 1982; 83: 239-248
49. Fox LS, Blackstone EH, Kirklin JW, Bishop SP, Bergdahl LA, Bradley EL Relationship of brain blood flow and oxygen consumption to perfusion flow rate during profoundly hypothermic cardiopulmonary bypass: an experimental study. J Thorac Cardiovasc Surg 1984; 87: 658-664
50. Greeley WJ, Ungerleider RM, Smith LR, Reves JG The effects of deep hypothermic cardiopulmonary bypass and total circulatory arrest on cerebral blood flow in infants and children. J Thorac Cardiovasc Surg 1989; 97: 737-745
51. Brunberg JA, Reilly EL, Doty DB Central nervous system consequences in infants of cardiac surgery using deep hypothermia and circulatory arrest. Circulation 1974; 50: Suppl II: II-60
52. Ehyai A, Fenichel GM, Bender HW Jr Incidence and prognosis of seizures in infants after cardiac surgery with profound hypothermia and circulatory arrest. JAMA 1984; 252: 3165-3167
53. Clarkson PM, MacArthur BA, Barratt-Boyes BG, Whitlock RM, Neutze JM Developmental progress after cardiac surgery in infancy using hypothermia and circulatory arrest. Circulation 1980; 62: 855-861
54. Choi DW Glutamate neurotoxicity and diseases of the nervous system. Neuron 1988; 1: 623-634
55. Rothman SM, Olney JW Glutamate and the pathophysiology of hypoxic-ischemic brain damage. Ann Neurol 1986; 19: 105-111
56. Miller LP, Johnson AE, Gelhard RE, Insel TR The ontogeny of excitatory amino acid receptors in the rat forebrain. II. Kainic acid receptors. Neuroscience 1990; 35: 45-51
57. Insel TR, Miller LP, Gelhard RE The ontogeny of excitatory amino acid receptors in rat forebrain. I. N-methyl-D-aspartate and quisqualate receptors. Neuroscience 1990; 35: 31-43
58. McDonald JW, Johnston MV Physiological and pathophysiological roles of excitatory amino acids during central nervous system development. Brain Res Brain Res Rev 1990; 15: 41-70
59. Moshe SL, Sharpless NS, Kaplan J Kindling in developing rats: variability of afterdischarge thresholds with age. Brain Res 1981; 211: 190-195
60. Volpe JJ. Neonatal seizures. In: Markowitz M, ed. Neurology of the newborn. 2nd ed. Philadelphia: W.B. Saunders, 1987:129-57.
61. Andre M, Matisse N, Vert P. Prognosis of neonatal seizures. In: Wasterlain CG, Vert P, eds. Neonatal seizures. New York: Raven Press, 1990:61-7.
62. Rose AL, Lombrosco CT Neonatal seizure states: a study of clinical, pathological, and electroencephalographic features in 137 full-term babies with a long-term follow-up. Pediatrics 1970; 45: 404-425
63. Legido A, Clancy RR, Berman PH Neurologic outcome after electroencephalographically proven neonatal seizures. Pediatrics 1991; 88: 583-596