Choreoathetosis after deep hypothermia without circulatory arrest
| Autor: | Anthony F. Cutilletta, Tarek Husayni, Jose A. Quinones, Mounir Y. Obeid, Alfonso Wong, Michel N. Ilbawi, Robert Egel, Rene A. Arcilla, Farouk S. Idriss, Rabi Sulayman, Serafin Y. DeLeon |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Reoperation
Pulmonary and Respiratory Medicine Resuscitation Choreoathetosis Group B Body Temperature law.invention Sepsis Chorea Hypothermia Induced law medicine Cardiopulmonary bypass Humans Athetosis Retrospective Studies Cardiopulmonary Bypass business.industry Incidence Incidence (epidemiology) Brain Infant Electroencephalography Hypothermia medicine.disease Echoencephalography Magnetic Resonance Imaging Child Preschool Anesthesia Surgery Atrophy medicine.symptom Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | The Annals of Thoracic Surgery. 50:714-719 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/0003-4975(90)90668-v |
| Popis: | In 8 of 758 patients undergoing an intracardiac operation under cardiopulmonary bypass and hypothermia, choreoathetosis developed 3 to 7 days postoperatively. Before the onset of choreoathetosis, varying degrees of neurological dysfunction were noted. Electroencephalography and neuroimaging failed to detect any responsible functional or structural changes. Six patients are alive 1 to 3 years postoperatively, and their condition is improving. Two patients died of aspiration or sepsis. All patients were grouped based on factors identified as being possibly causative: depth of hypothermia, cooling time, flow rate, and repeated hypothermia. The incidence of choreoathetosis was significantly different in group A (rectal temperature greater than 25 degrees C) compared with group B (rectal temperature less than or equal to 25 degrees C) (0/295 versus 8/463; p = 0.02). Based on cooling time, the incidence of choreoathetosis was significantly different in group B1 (cooling time less than 1 hour) compared with group B2 (cooling time greater than or equal to 1 hour) (1/220 versus 7/243; p = 0.05). Based on flow rate during cooling, group B2 was further divided into the low-flow group (less than 1,500 mL.min-1.m-2) and the high-flow group (greater than or equal to 1,500 mL.min-1.m-2). Although not significant, the incidence of choreoathetosis was higher in the high-flow group (6/153 versus 1/90; p = 0.22). In group B patients having reoperation, the incidence of choreoathetosis was higher than in patients operated on for the first time (5/54 versus 3/409; p less than or equal to 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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