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Normothermic cardiopulmonary bypass: effect on the incidence of persistent postoperative neurological dysfunction following coronary artery bypass graft surgery
Authors:Koichiroh Nandate  Kenji Muranaka  Koichi Shinohara  Kazuyoshi Ishida  Hiroko Ishida  Katsuhiro Seo  Hiroshi Takeshita
Institution:(1) Department of Anesthesiology, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokurakita-ku, 802 Kitakyushu, Japan;(2) Department of Intensive Care Medicine, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokurakita-ku, 802 Kitakyushu, Japan
Abstract:We retrospectively reviewed the records of 250 consecutive patients undergoing coronary artery bypass graft surgery (CABG) from January 1994 through January 1996 to determine the incidence of persistent postoperative neurological dysfunction after CABG and to compare normothermic and moderate hypothermic cardiopulmonary bypass (CPB). Normothermic CPB was used in 128 patients (36°–37°C) and hypothermic CPB (27°–28°C) in 122 patients. Postoperative neurological dysfunction included focal motor deficits, delayed recovery of consciousness (>24h) after surgery, and seizures within 1 week postoperatively. Persistent neurological dysfunction was diagnosed if complete resolution had not occurred within 10 days of surgery. The incidence of persistent postoperative neurological dysfunction was 4.1% in the hypothermic CPB group and 2.3% in the normothermic CPB group. There were no statistically significant differences between the two groups (P=NS). These results suggest that normothermic CPB did not increase the incidence of persistent postoperative neurological dysfunction compared to hypothermic CPB.
Keywords:Postoperative complication  Neurological dysfunction  Temperature  Hypothermia  Cardiopulmonary bypass  Coronary artery bypass graft surgery
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