Centrifugal versus roller head pumps for cardiopulmonary bypass: effect on early neuropsychologic outcomes after coronary artery surgery
| Autor: | Carolyn Blyth, Mary C. Borton, David Scott, Brendan S. Silbert, David J. de L. Horne, Timothy J. Doyle, Jennifer L. O'Brien |
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| Rok vydání: | 2002 |
| Předmět: |
Male
medicine.medical_specialty Randomization Neuropsychological Tests law.invention Postoperative Complications Randomized controlled trial Double-Blind Method law Cardiopulmonary bypass medicine Humans Prospective Studies Coronary Artery Bypass Aged Cardiopulmonary Bypass business.industry Incidence (epidemiology) Odds ratio Length of Stay Middle Aged Intensive care unit Confidence interval Surgery Clinical trial Anesthesiology and Pain Medicine Anesthesia Female Cardiology and Cardiovascular Medicine business Cognition Disorders |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 16(6) |
| ISSN: | 1053-0770 |
| Popis: | Objective: To test the hypothesis that routine use of a centrifugal pump in the cardiopulmonary bypass circuit would result in a lower incidence of early neuropsychologic deficit when compared with conventional roller pumps. Design: Prospective, randomized, double-blind. Setting: University teaching hospital. Participants: Patients (n = 103) scheduled for elective coronary artery surgery. Interventions: Patients were randomized into group C (centrifugal pump for cardiopulmonary bypass; n = 54) and group R (roller pump for cardiopulmonary bypass; n = 49). Measurements and Main Results: A neuropsychologic test battery of 6 standard tests was administered before surgery and 5 days after surgery. An abnormal test result was defined as deterioration by >1 group SD from an individual's preoperative test performance. There were no significant differences between groups in preoperative or surgical parameters, intensive care unit stay, or hospital stay. There were no significant differences in the incidence of neuropsychologic deficit for patients with a deficit in at least 1 test (group C, 33%; group R, 51%; odds ratio, 0.48; 95% confidence interval, 0.22 to 1.06) or patients with a deficit in ≥2 tests (group C, 6%; group R, 18%; odds ratio, 0.26; 95% confidence interval, 0.07 to 1.03). In group R, there were more individual test deficits per patient than in group C ( p = 0.04). Conclusion: There was no significant difference in the incidence of neuropsychologic deficit postoperatively with routine use of centrifugal pumps. The larger number of individual test deficits in the roller pump group suggest that further studies to assess the potential neuropsychologic benefits of the use of centrifugal pumps are warranted. Copyright 2002, Elsevier Science (USA). All rights reserved. |
| Databáze: | OpenAIRE |
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