OBJECTIVE: To determine the effect of arterial normobaric hyperoxia during cardiopulmonary bypass (CPB) on postoperative neurocognitive function. The authors hypothesized that arterial hyperoxia during CPB is associated with neurocognitive decline at 6 weeks after cardiac surgery. DESIGN: Retrospective study of patients undergoing cardiac surgery with CPB. SETTING: A university hospital. PARTICIPANTS: One thousand eighteen patients undergoing coronary artery bypass graft (CABG) or CABG + valve surgery with CPB who previously had been enrolled in prospective cognitive trials. INTERVENTIONS: A battery of neurocognitive measures was administered at baseline and 6 weeks after surgery. Anesthetic and surgical care was managed as clinically indicated. MEASUREMENTS AND MAIN RESULTS: Arterial hyperoxia was assessed primarily as the area under the curve (AUC) for the duration that PaO2 exceeded 200 mmHg during CPB and secondarily as the mean PaO2 during bypass, as a PaO2 = 300 mmHg at any point and as AUC>150 mmHg. Cognitive change was assessed both as a continuous change score and a dichotomous deficit rate. Multivariate regression accounting for age, years of education, baseline cognition, date of surgery, baseline postintubation PaO2, duration of CPB, and percent change in hematocrit level from baseline to lowest level during CPB revealed no significant association between hyperoxia during CPB and postoperative neurocognitive function. CONCLUSIONS: Arterial hyperoxia during CPB was not associated with neurocognitive decline after 6 weeks in cardiac surgical patients.
OBJECTIVE: To determine the effect of arterial normobaric hyperoxia during cardiopulmonary bypass (CPB) on postoperative neurocognitive function. The authors hypothesized that arterial hyperoxia during CPB is associated with neurocognitive decline at 6 weeks after cardiac surgery. DESIGN: Retrospective study of patients undergoing cardiac surgery with CPB. SETTING: A university hospital. PARTICIPANTS: One thousand eighteen patients undergoing coronary artery bypass graft (CABG) or CABG + valve surgery with CPB who previously had been enrolled in prospective cognitive trials. INTERVENTIONS: A battery of neurocognitive measures was administered at baseline and 6 weeks after surgery. Anesthetic and surgical care was managed as clinically indicated. MEASUREMENTS AND MAIN RESULTS:Arterial hyperoxia was assessed primarily as the area under the curve (AUC) for the duration that PaO2 exceeded 200 mmHg during CPB and secondarily as the mean PaO2 during bypass, as a PaO2 = 300 mmHg at any point and as AUC>150 mmHg. Cognitive change was assessed both as a continuous change score and a dichotomous deficit rate. Multivariate regression accounting for age, years of education, baseline cognition, date of surgery, baseline postintubation PaO2, duration of CPB, and percent change in hematocrit level from baseline to lowest level during CPB revealed no significant association between hyperoxia during CPB and postoperative neurocognitive function. CONCLUSIONS:Arterial hyperoxia during CPB was not associated with neurocognitive decline after 6 weeks in cardiac surgical patients.
Authors: M F Newman; J L Kirchner; B Phillips-Bute; V Gaver; H Grocott; R H Jones; D B Mark; J G Reves; J A Blumenthal Journal: N Engl J Med Date: 2001-02-08 Impact factor: 91.245
Authors: A M Grigore; J Mathew; H P Grocott; J G Reves; J A Blumenthal; W D White; P K Smith; R H Jones; J L Kirchner; D B Mark; M F Newman Journal: Anesthesiology Date: 2001-11 Impact factor: 7.892
Authors: J Hope Kilgannon; Alan E Jones; Joseph E Parrillo; R Phillip Dellinger; Barry Milcarek; Krystal Hunter; Nathan I Shapiro; Stephen Trzeciak Journal: Circulation Date: 2011-05-23 Impact factor: 29.690
Authors: J Hope Kilgannon; Alan E Jones; Nathan I Shapiro; Mark G Angelos; Barry Milcarek; Krystal Hunter; Joseph E Parrillo; Stephen Trzeciak Journal: JAMA Date: 2010-06-02 Impact factor: 56.272
Authors: George Djaiani; Ludwik Fedorko; Michael A Borger; Robin Green; Jo Carroll; Michael Marcon; Jacek Karski Journal: Circulation Date: 2007-10-08 Impact factor: 29.690
Authors: Joseph P Mathew; G Burkhard Mackensen; Barbara Phillips-Bute; Hilary P Grocott; Donald D Glower; Daniel T Laskowitz; James A Blumenthal; Mark F Newman Journal: Stroke Date: 2009-01-22 Impact factor: 7.914
Authors: Miles Berger; Niccolò Terrando; S Kendall Smith; Jeffrey N Browndyke; Mark F Newman; Joseph P Mathew Journal: Anesthesiology Date: 2018-10 Impact factor: 7.892
Authors: Shahzad Shaefi; Puja Shankar; Ariel L Mueller; Brian P O'Gara; Kyle Spear; Kamal R Khabbaz; Aranya Bagchi; Louis M Chu; Valerie Banner-Goodspeed; David E Leaf; Daniel S Talmor; Edward R Marcantonio; Balachundhar Subramaniam Journal: Anesthesiology Date: 2021-02-01 Impact factor: 7.892
Authors: Shahzad Shaefi; Edward R Marcantonio; Ariel Mueller; Valerie Banner-Goodspeed; Simon C Robson; Kyle Spear; Leo E Otterbein; Brian P O'Gara; Daniel S Talmor; Balachundhar Subramaniam Journal: Trials Date: 2017-12-19 Impact factor: 2.279
Authors: Deborah M Oyeyemi; Mary Cooter; Stacey Chung; Heather E Whitson; Jeffrey N Browndyke; Michael J Devinney; Patrick J Smith; Grant E Garrigues; Eugene Moretti; Judd W Moul; Harvey Jay Cohen; Joseph P Mathew; Miles Berger Journal: J Geriatr Psychiatry Neurol Date: 2020-12-30 Impact factor: 2.680