The Journal of Thoracic and Cardiovascular Surgery
Volume 133, Issue 5 , Pages 1206-1211 , May 2007

Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass: Five-year follow-up of a randomized trial

  • Howard J. Nathan, MD

      Affiliations

    • Department of Anesthesiology, University of Ottawa, Ottawa, Canada
    • Corresponding Author InformationAddress for reprints: H. J. Nathan, MD, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario K1Y 4W7, Canada.
    • ,
  • Rosendo Rodriguez, MD

      Affiliations

    • Department of Surgery, University of Ottawa, Ottawa, Canada
    • ,
  • Denise Wozny, BA

      Affiliations

    • Department of Anesthesiology, University of Ottawa, Ottawa, Canada
    • ,
  • Jean-Yves Dupuis, MD

      Affiliations

    • Department of Anesthesiology, University of Ottawa, Ottawa, Canada
    • ,
  • Fraser D. Rubens, MD

      Affiliations

    • Department of Surgery, University of Ottawa, Ottawa, Canada
    • ,
  • Gregory L. Bryson, MD

      Affiliations

    • Department of Anesthesiology, University of Ottawa, Ottawa, Canada
    • ,
  • George Wells, PhD

      Affiliations

    • Department of Epidemiology, University of Ottawa, Ottawa, Canada.

Received 2 May 2006 ,Revised 4 July 2006 ,Accepted 11 September 2006.

References 

  1. Selnes OA, Goldsborough MA, Borowicz LM, McKhann GM. Neurobehavioural sequelae of cardiopulmonary bypass. Lancet. 1999;353:1601–1606
  2. Newman MF, Grocott HP, Mathew JP, White WD, Landolfo K, Reves JG, et al. Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery. Stroke. 2001;32:2874–2881
  3. Brown WR, Moody DM, Challa VR, Stump DA, Hammon JW. Longer duration of cardiopulmonary bypass is associated with greater numbers of cerebral microemboli. Stroke. 2000;31:707–713
  4. The Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346:549–556
  5. Nathan HJ, Wells GA, Munson JL, Wozny D. Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass: a randomized trial. Circulation. 2001;104(12 suppl 1):I85–I91
  6. Newman MF, Kirchner JL, Phillips-Bute B, Gaver V, Grocott H, Jones RH, et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001;344:395–402
  7. Stygall J, Newman SP, Fitzgerald G, Steed L, Mulligan K, Arrowsmith JE, et al. Cognitive change 5 years after coronary artery bypass surgery. Health Psychol. 2003;22:579–586
  8. Selnes OA, Royall RM, Grega MA, Borowicz LM, Quaskey S, McKhann GM. Cognitive changes 5 years after coronary artery bypass grafting: is there evidence of late decline?. Arch Neurol. 2001;58:598–604
  9. Wilson RS, Beckett LA, Bennett DA, Albert MS, Evans DA. Change in cognitive function in older persons from a community population: relation to age and Alzheimer disease. Arch Neurol. 1999;56:1274–1279
  10. Rubin EH, Storandt M, Miller JP, Kinscherf DA, Grant EA, Morris JC, et al. A prospective study of cognitive function and onset of dementia in cognitively healthy elders. Arch Neurol. 1998;55:395–401
  11. Selnes OA, Grega MA, Borowicz LM, Barry S, Zeger S, Baumgartner WA, et al. Cognitive outcomes three years after coronary artery bypass surgery: a comparison of on-pump coronary artery bypass graft surgery and nonsurgical controls. Ann Thorac Surg. 2005;79:1201–1209
  12. Murkin JM, Stump DA, Blumenthal JA, McKhann G. Defining dysfunction: group means versus incidence analysis—a statement of consensus. Ann Thorac Surg. 1997;64:904–905
  13. McLean RF, Wong BI, Naylor CD, Snow WG, Harrington EM, Gawel M, et al. Cardiopulmonary bypass, temperature, and central nervous system dysfunction. Circulation. 1994;90(5 Pt 2):II250–II255
  14. Engelman RM, Pleet AB, Rousou JA, Flack JE, Deaton DW, Pekow PS, et al. Influence of cardiopulmonary bypass perfusion temperature on neurologic and hematologic function after coronary artery bypass grafting. Ann Thorac Surg. 1999;67:1547–1556
  15. Plourde G, Leduc AS, Morin JE, DeVarennes B, Latter D, Symes J, et al. Temperature during cardiopulmonary bypass for coronary artery operations does not influence postoperative cognitive function: a prospective, randomized trial. J Thorac Cardiovasc Surg. 1997;114:123–128
  16. Grigore AM, Mathew J, Grocott HP, Reves JG, Blumenthal JA, White WD, et al. Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery. Anesthesiology. 2001;95:1110–1119
  17. Regragui I, Birdi I, Izzat MB, Black AMS, Lopatatzidis A, Day CJE, et al. The effects of cardiopulmonary bypass temperature on neuropsychologic outcome after coronary artery operations: a prospective randomized trial. J Thorac Cardiovasc Surg. 1996;112:1036–1045
  18. Mora CT, Henson MB, Weintraub WS, Murkin JM, Martin TD, Craver JM, et al. The effect of temperature management during cardiopulmonary bypass on neurologic and neuropsychologic outcomes in patients undergoing coronary revascularization. J Thorac Cardiovasc Surg. 1996;112:514–522
  19. Nathan HJ, Lavallee G. The management of temperature during hypothermic cardiopulmonary bypass (I. Canadian survey). Can J Anaesth. 1995;42:669–671
  20. Colbourne F, Sutherland G, Corbett D. Postischemic hypothermia (A critical appraisal with implications for clinical treatment). Mol Neurobiol. 1997;14:171–201
  21. Nathan HJ, Parlea L, Dupuis JY, Hendry P, Williams KA, Rubens FD, et al. Safety of deliberate intraoperative and postoperative hypothermia for patients undergoing coronary artery surgery: a randomized trial. J Thorac Cardiovasc Surg. 2004;127:1270–1275
  22. Murkin JM, Newman SP, Stump DA, Blumenthal JA. Statement of consensus on assessment of neurobehavioural outcomes after cardiac surgery. Ann Thorac Surg. 1995;59:1289–1295
  23. Barry SJ, Zeger SL, Selnes OA, Grega MA, Borowicz LM, McKhann GM. Quantitative methods for tracking cognitive change 3 years after coronary artery bypass surgery. Ann Thorac Surg. 2005;79:1104–1109

 Funded by the Heart and Stroke Foundation of Ontario and the Canadian Institutes of Health Research.

PII: S0022-5223(06)02195-7

doi: 10.1016/j.jtcvs.2006.09.112

The Journal of Thoracic and Cardiovascular Surgery
Volume 133, Issue 5 , Pages 1206-1211 , May 2007

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