Scholars@Duke
Mark Franklin Newman

Mark Franklin Newman

Merel H. Harmel Distinguished Professor Emeritus of Anesthesiology
Anesthesiology, Cardiothoracic
newma005@mc.duke.edu
Box 3810, 1293 Orange Zone, Duke South, Durham, NC 27710
200 Trent Drive, 1293 Orange Zone, Durham, NC 27710

Selected Publications

A pilot study of longitudinal changes in neurocognition, white matter hyperintensities, and cortical thickness in atrial fibrillation patients following catheter ablation vs medical management.

Journal Article Heart Rhythm O2 · February 2024 BACKGROUND: Cerebral microembolization and atrophy complicate atrial fibrillation (AF). OBJECTIVES: We aimed to compare changes in neuroimaging findings between AF patients treated with catheter ablation and those treated with medical therapy. METHODS: In ... Full text Link to item Cite

Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study.

Journal Article Br J Anaesth · December 2021 BACKGROUND: Cognitive dysfunction after surgery is a major issue in older adults. Here, we determined the effect of APOE4 on perioperative neurocognitive function in older patients. METHODS: We enrolled 140 English-speaking patients ≥60 yr old scheduled fo ... Full text Open Access Link to item Cite

Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.

Journal Article Sci Rep · February 4, 2021 Arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA) derived lipids play key roles in initiating and resolving inflammation. Neuro-inflammation is thought to play a causal role in perioperative neurocognitive disorders, yet th ... Full text Open Access Link to item Cite

Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.

Journal Article J Alzheimers Dis · 2021 BACKGROUND: Postoperative cognitive dysfunction (POCD), a syndrome of cognitive deficits occurring 1-12 months after surgery primarily in older patients, is associated with poor postoperative outcomes. POCD is hypothesized to result from neuroinflammation; ... Full text Open Access Link to item Cite

Postoperative Cognitive Dysfunction and Delirium

Chapter · January 1, 2021 The brain is amazingly interesting and complex. As neuroscience progresses, we gain a broader understanding of specialized regional activity, chemistry and unique interconnections that makes us the fascinating and diverse organisms that we are. However, th ... Full text Cite

Introduction

Journal Article Perioperative Medicine: Managing for Outcome, Second Edition · January 1, 2021 Full text Cite

Introduction

Journal Article Perioperative Medicine: Managing for Outcome, Second Edition · January 1, 2021 Full text Cite

Introduction

Journal Article Perioperative Medicine: Managing for Outcome, Second Edition · January 1, 2021 Full text Cite

Introduction

Journal Article Perioperative Medicine: Managing for Outcome, Second Edition · January 1, 2021 Full text Cite

Introduction

Journal Article Perioperative Medicine: Managing for Outcome, Second Edition · January 1, 2021 Full text Cite

Perioperative Medicine: Managing for Outcome, Second Edition

Book · January 1, 2021 Based on the most current evidence and best practices, Perioperative Medicine: Managing for Outcome, 2nd Edition, is an easy-to-follow, authoritative guide to achieving optimal outcomes in perioperative care. Written and edited by recognized authorities in ... Full text Cite

Implications of Perioperative Morbidity for Long-Term Outcomes

Chapter · January 1, 2021 Though multidisciplinary efforts to reduce morbidity and mortality have improved outcomes for surgical patients, our understanding of this problem is still evolving. There are both fixed and modifiable factors that influence a patient's surgical course. Th ... Full text Cite

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.

Journal Article J Neurol · July 2020 OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort st ... Full text Link to item Cite

Securing a Network for a Research-Intensive, Referral Academic Medical Center: University of Kentucky HealthCare as a Case Study.

Journal Article Acad Med · December 2019 Over the last 15 years, UK HealthCare, the clinical enterprise of the University of Kentucky, has undertaken 3 clinical strategic plans to secure its position as a research-intensive, referral academic medical center. The first plan, titled Securing the Tr ... Full text Link to item Cite

Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study.

Journal Article Anesth Analg · November 2019 Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery ... Full text Open Access Link to item Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Longitudinal Changes in Regional Cerebral Perfusion and Cognition After Cardiac Operation.

Journal Article Ann Thorac Surg · January 2019 BACKGROUND: Cardiac operation has been associated with increased risk of postoperative cognitive decline, as well as dementia risk in the general population. Few studies, however, have examined the impact of coronary revascularization or valve replacement ... Full text Open Access Link to item Cite

Neurocognitive Function after Cardiac Surgery: From Phenotypes to Mechanisms.

Journal Article Anesthesiology · October 2018 For half a century, it has been known that some patients experience neurocognitive dysfunction after cardiac surgery; however, defining its incidence, course, and causes remains challenging and controversial. Various terms have been used to describe neuroc ... Full text Link to item Cite

Designing risk prediction models for ambulatory no-shows across different specialties and clinics.

Journal Article J Am Med Inform Assoc · August 1, 2018 OBJECTIVE: As available data increases, so does the opportunity to develop risk scores on more refined patient populations. In this paper we assessed the ability to derive a risk score for a patient no-showing to a clinic visit. METHODS: Using data from 2  ... Full text Open Access Link to item Cite

Predictive ability of perioperative atrial fibrillation risk indices in cardiac surgery patients: a retrospective cohort study.

Journal Article Can J Anaesth · July 2018 PURPOSE: The Multicenter Study of Perioperative Ischemia (McSPI) AFRisk index predicts postoperative atrial fibrillation (POAF) after cardiac surgery, but requires pre-, intra-, and postoperative data. Other more abbreviated risk indices exist, but there i ... Full text Link to item Cite

Dual antiplatelet therapy for perioperative myocardial infarction following CABG surgery.

Journal Article Am Heart J · May 2018 OBJECTIVES: Perioperative myocardial infarction (MI) after coronary artery bypass graft surgery (CABG) has been associated with adverse outcome. Whether perioperative MI should be treated with dual antiplatelet therapy (DAPT) is unknown. We compared the ef ... Full text Link to item Cite

18F-florbetapir Positron Emission Tomography-determined Cerebral β-Amyloid Deposition and Neurocognitive Performance after Cardiac Surgery.

Journal Article Anesthesiology · April 2018 BACKGROUND: Amyloid deposition is a potential contributor to postoperative cognitive dysfunction. The authors hypothesized that 6-week global cortical amyloid burden, determined by F-florbetapir positron emission tomography, would be greater in those patie ... Full text Link to item Cite

Task-related changes in degree centrality and local coherence of the posterior cingulate cortex after major cardiac surgery in older adults.

Journal Article Hum Brain Mapp · February 2018 OBJECTIVES: Older adults often display postoperative cognitive decline (POCD) after surgery, yet it is unclear to what extent functional connectivity (FC) alterations may underlie these deficits. We examined for postoperative voxel-wise FC changes in respo ... Full text Open Access Link to item Cite

Resting-State Functional Connectivity and Cognition After Major Cardiac Surgery in Older Adults without Preoperative Cognitive Impairment: Preliminary Findings.

Journal Article J Am Geriatr Soc · January 2017 OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging. DESIGN: Obj ... Full text Open Access Link to item Cite

Intraoperative Frontal Alpha-Band Power Correlates with Preoperative Neurocognitive Function in Older Adults.

Journal Article Front Syst Neurosci · 2017 Each year over 16 million older Americans undergo general anesthesia for surgery, and up to 40% develop postoperative delirium and/or cognitive dysfunction (POCD). Delirium and POCD are each associated with decreased quality of life, early retirement, incr ... Full text Open Access Link to item Cite

The Effect of Propofol vs. Isoflurane Anesthesia on Postoperative Changes in Cerebrospinal Fluid Cytokine Levels: Results from a Randomized Trial.

Journal Article Front Immunol · 2017 INTRODUCTION: Aside from direct effects on neurotransmission, inhaled and intravenous anesthetics have immunomodulatory properties. In vitro and mouse model studies suggest that propofol inhibits, while isoflurane increases, neuroinflammation. If these fin ... Full text Link to item Cite

Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial.

Journal Article Can J Anaesth · November 2016 PURPOSE: Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral in ... Full text Link to item Cite

The Effect of Propofol Versus Isoflurane Anesthesia on Human Cerebrospinal Fluid Markers of Alzheimer's Disease: Results of a Randomized Trial.

Journal Article J Alzheimers Dis · April 15, 2016 BACKGROUND: Preclinical studies have found differential effects of isoflurane and propofol on the Alzheimer's disease (AD)-associated markers tau, phosphorylated tau (p-tau) and amyloid-β (Aβ). OBJECTIVE: We asked whether isoflurane and propofol have diffe ... Full text Open Access Link to item Cite

Gene signatures of postoperative atrial fibrillation in atrial tissue after coronary artery bypass grafting surgery in patients receiving β-blockers.

Journal Article J Mol Cell Cardiol · March 2016 Atrial tissue gene expression profiling may help to determine how differentially expressed genes in the human atrium before cardiopulmonary bypass (CPB) are related to subsequent biologic pathway activation patterns, and whether specific expression profile ... Full text Link to item Cite

Merel Harmel: Portrait of an Anesthesiology Pioneer.

Journal Article Anesth Analg · February 2016 Merel Harmel, MD, was the first anesthesiologist to give anesthesia for a palliative congenital heart operation performed by Alfred Blalock, MD. He was the first resident in anesthesiology at Johns Hopkins and was the first academic department chairman at ... Full text Link to item Cite

Genome-wide association study of acute kidney injury after coronary bypass graft surgery identifies susceptibility loci.

Journal Article Kidney Int · October 2015 Acute kidney injury (AKI) is a common, serious complication of cardiac surgery. Since prior studies have supported a genetic basis for postoperative AKI, we conducted a genome-wide association study (GWAS) for AKI following coronary bypass graft (CABG) sur ... Full text Open Access Link to item Cite

Intraoperative Magnesium Administration Does Not Reduce Postoperative Atrial Fibrillation After Cardiac Surgery.

Journal Article Anesth Analg · October 2015 BACKGROUND: Hypomagnesemia has been associated with an increased risk of postoperative atrial fibrillation (POAF). Although previous studies have suggested a beneficial effect of magnesium (Mg) therapy, almost all of these are limited by small sample size ... Full text Link to item Cite

Genome-wide association study of new-onset atrial fibrillation after coronary artery bypass grafting surgery.

Journal Article Am Heart J · September 2015 BACKGROUND: Postoperative atrial fibrillation (AF) is a potentially life-threatening complication after coronary artery bypass graft (CABG) surgery. Genetic predisposition may predict risk for developing postoperative AF. METHODS: Study subjects underwent ... Full text Link to item Cite

Apolipoprotein epsilon 4 genotype is associated with less improvement in cognitive function five years after cardiac surgery: a retrospective cohort study.

Journal Article Can J Anaesth · June 2015 PURPOSE: Cognitive performance after cardiac surgery can be impaired, and genetic risk factors have previously been suggested. When compared with other isoforms of the gene, the apolipoprotein epsilon 4 (APOE4) allele is associated with worse outcomes in m ... Full text Link to item Cite

Genome-wide association study of perioperative myocardial infarction after coronary artery bypass surgery.

Journal Article BMJ Open · May 6, 2015 OBJECTIVES: Identification of patient subpopulations susceptible to develop myocardial infarction (MI) or, conversely, those displaying either intrinsic cardioprotective phenotypes or highly responsive to protective interventions remain high-priority knowl ... Full text Open Access Link to item Cite

Predictors of contemporary coronary artery bypass grafting outcomes.

Journal Article J Thorac Cardiovasc Surg · December 2014 OBJECTIVES: The study objective was to identify the predictors of outcomes in a contemporary cohort of patients from the Reduction in cardiovascular Events by acaDesine in patients undergoing CABG (RED-CABG) trial. Despite the increasing risk profile of pa ... Full text Link to item Cite

ABO blood group influences transfusion and survival after cardiac surgery.

Journal Article J Thromb Thrombolysis · October 2014 ABO dependent variation in von Willebrand factor (vWf) and procoagulant factor VIII (FVIII) is a plausible mechanism for modulating perioperative hemostasis and bleeding. Group AB has the highest and group O the lowest vWf and FVIII levels. Therefore, we t ... Full text Link to item Cite

G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving β-blockers.

Other Circ Cardiovasc Genet · October 2014 BACKGROUND: We hypothesized that genetic variations in the adrenergic signaling pathway and cytochrome P450 2D6 enzyme are associated with new-onset atrial fibrillation (AF) in patients who underwent coronary artery bypass grafting and were treated with pe ... Full text Link to item Cite

Arterial hyperoxia during cardiopulmonary bypass and postoperative cognitive dysfunction.

Journal Article J Cardiothorac Vasc Anesth · June 2014 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 wee ... Full text Link to item Cite

Neurological complications of cardiac surgery.

Journal Article Lancet Neurol · May 2014 As increasing numbers of elderly people undergo cardiac surgery, neurologists are frequently called upon to assess patients with neurological complications from the procedure. Some complications mandate acute intervention, whereas others need longer term o ... Full text Link to item Cite

Preoperative CYP2D6 metabolism-dependent β-blocker use and mortality after coronary artery bypass grafting surgery.

Journal Article J Thorac Cardiovasc Surg · April 2014 OBJECTIVE: Recently, the role of β-blockers (BBs) in reducing perioperative mortality has been challenged. The conflicting results might have resulted from the extent of BB metabolism by the cytochrome P-450 (CYP2D6) isoenzyme. The purpose of the present s ... Full text Open Access Link to item Cite

Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Journal Article Stroke · December 2013 BACKGROUND AND PURPOSE: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl ... Full text Link to item Cite

Cortical β-amyloid levels and neurocognitive performance after cardiac surgery.

Journal Article BMJ Open · September 20, 2013 INTRODUCTION: Neurological and neurocognitive dysfunction occurs frequently in the large number of increasingly elderly patients undergoing cardiac surgery every year. Perioperative cognitive deficits have been shown to persist after discharge and up to se ... Full text Open Access Link to item Cite

Predictors of cognitive recovery after cardiac surgery.

Journal Article Anesth Analg · February 2013 BACKGROUND: Postoperative neurocognitive decline occurs frequently. Although predictors of cognitive injury have been well examined, factors that modulate recovery have not. We sought to determine the predictors of cognitive recovery after initial injury f ... Full text Link to item Cite

Neurocognitive outcomes after cardiac surgery.

Journal Article Curr Opin Anaesthesiol · February 2013 PURPOSE OF REVIEW: To summarize recent studies of neurocognitive dysfunction after cardiac surgery, as well as to outline efforts and approaches toward advancing the field. RECENT FINDINGS: Observational studies have improved our understanding of the incid ... Full text Link to item Cite

The association of postcardiac surgery acute kidney injury with intraoperative systolic blood pressure hypotension.

Journal Article Anesthesiol Res Pract · 2013 Background. Postoperative acute kidney injury (AKI) is associated with high mortality and substantial cost after aortocoronary bypass graft (CABG) surgery. We tested the hypothesis that intraoperative systolic blood pressure variation is associated with po ... Full text Open Access Link to item Cite

Effect of adenosine-regulating agent acadesine on morbidity and mortality associated with coronary artery bypass grafting: the RED-CABG randomized controlled trial.

Journal Article JAMA · July 11, 2012 CONTEXT: Ischemia/reperfusion injury remains an important cause of morbidity and mortality after coronary artery bypass graft (CABG) surgery. In a meta-analysis of randomized controlled trials, perioperative and postoperative infusion of acadesine, a first ... Full text Link to item Cite

Population pharmacokinetics of lidocaine administered during and after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · December 2011 OBJECTIVE: The objective of this study was to determine the pharmacokinetics of lidocaine in a 48-hour infusion in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). DESIGN: A retrospective substudy of a clinical trial assessing the eff ... Full text Link to item Cite

Thrombomodulin gene variants are associated with increased mortality after coronary artery bypass surgery in replicated analyses.

Journal Article Circulation · September 13, 2011 BACKGROUND: We tested the hypothesis that genetic variation in thrombotic and inflammatory pathways is independently associated with long-term mortality after coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Two separate cohorts of patient ... Full text Link to item Cite

Does perioperative systolic blood pressure variability predict mortality after cardiac surgery? An exploratory analysis of the ECLIPSE trials.

Journal Article Anesth Analg · July 2011 BACKGROUND: Few studies describe an association of perioperative blood pressure stability with postoperative outcome. We tested the hypothesis that systolic blood pressure (SBP) variability in patients undergoing cardiac surgery is associated with 30-day m ... Full text Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

Storage age of transfused platelets and outcomes after cardiac surgery.

Journal Article Transfusion · November 2010 BACKGROUND: The relationship between duration of platelet (PLT) storage, currently limited to 5days, and surgical outcomes has not been established. We tested the hypothesis that PLT storage age was associated with adverse outcomes. STUDY DESIGN AND METHOD ... Full text Link to item Cite

Departures from the protocol during conduct of a clinical trial: a pattern from the data record consistent with a learning curve.

Journal Article Qual Saf Health Care · October 2010 OBJECTIVE: Recognition of learning curves in medical skill acquisition has enhanced patient safety through improved training techniques. Clinical trials research has not been similarly scrutinised. The VALsartan In Acute myocardial iNfarcTion, a large mult ... Full text Link to item Cite

Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients.

Journal Article Anesthesiology · August 2010 BACKGROUND: Few data support an association between blood pressure variability and clinical outcomes during cardiac surgery. We tested the hypothesis that intraoperative systolic blood pressure variability outside a targeted blood pressure range predicts 3 ... Full text Link to item Cite

Association of the 98T ELAM-1 polymorphism with increased bleeding after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2010 OBJECTIVE: Hemorrhage continues to be a major problem after cardiac surgery despite the routine use of antifibrinolytic drugs, with striking inter-patient variability poorly explained by already known risk factors. The authors tested the hypothesis that ge ... Full text Link to item Cite

Cognitive function after major noncardiac surgery, apolipoprotein E4 genotype, and biomarkers of brain injury.

Other Anesthesiology · April 2010 BACKGROUND: Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 ... Full text Link to item Cite

Impact of early renal recovery on survival after cardiac surgery-associated acute kidney injury.

Journal Article Ann Thorac Surg · April 2010 BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a major postoperative complication. Although some early recovery is common, its effect on long-term outcomes is unclear. We tested the hypothesis that early renal recovery after CSA-AK ... Full text Link to item Cite

Pulse pressure and long-term survival after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 1, 2010 BACKGROUND: Data from longitudinal studies reveal that widened pulse pressure (PP) is a major predictor of coronary heart disease and mortality, but it is unknown whether PP similarly decreases survival after coronary artery bypass graft (CABG) surgery for ... Full text Link to item Cite

In reply

Journal Article Anesthesiology · January 1, 2010 Full text Cite

A prospective, double-blind, randomized clinical feasibility trial of controlling the storage age of red blood cells for transfusion in cardiac surgical patients.

Journal Article Transfusion · July 2009 BACKGROUND: Recent evidence demonstrates an association between duration of storage of red blood cells (RBC) and morbidity and mortality after cardiac surgery. We studied the feasibility of two different schemes for categorizing and randomizing age of RBC ... Full text Link to item Cite

Randomized, double-blinded, placebo controlled study of neuroprotection with lidocaine in cardiac surgery.

Journal Article Stroke · March 2009 BACKGROUND AND PURPOSE: Cognitive decline after cardiac surgery remains common and diminishes patients' quality of life. Based on experimental and clinical evidence, this study assessed the potential of intravenously administered lidocaine to reduce postop ... Full text Link to item Cite

Relationship of genetic variability and depressive symptoms to adverse events after coronary artery bypass graft surgery.

Journal Article Psychosom Med · November 2008 OBJECTIVE: To assess genetic variability in two serotonin-related gene polymorphisms (MAOA-uVNTR and 5HTTLPR) and their relationships to depression and adverse cardiac events in a sample of patients undergoing coronary artery bypass surgery. METHODS: A tot ... Full text Link to item Cite

The ECLIPSE trials: comparative studies of clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine for acute hypertension treatment in cardiac surgery patients.

Journal Article Anesth Analg · October 2008 BACKGROUND: Acute hypertension during cardiac surgery can be difficult to manage and may adversely affect patient outcomes. Clevidipine is a novel, rapidly acting dihydropyridine L-type calcium channel blocker with an ultrashort half-life that decreases ar ... Full text Link to item Cite

Treatment of acute postoperative hypertension in cardiac surgery patients: an efficacy study of clevidipine assessing its postoperative antihypertensive effect in cardiac surgery-2 (ESCAPE-2), a randomized, double-blind, placebo-controlled trial.

Journal Article Anesth Analg · July 2008 BACKGROUND: Acute postoperative hypertension is a well-known complication of cardiac surgery and is associated with postoperative morbidity. Clevidipine, an ultrashort-acting, third-generation dihydropyridine calcium channel blocker, exerts vascular-select ... Full text Link to item Cite

The effect of aprotinin on outcome after coronary-artery bypass grafting.

Journal Article N Engl J Med · February 21, 2008 BACKGROUND: Aprotinin has recently been associated with adverse outcomes in patients undergoing cardiac surgery. We reviewed our experience with this agent in patients undergoing cardiac surgery at Duke University Medical Center. METHODS: We retrieved data ... Full text Link to item Cite

Anaesthesia and the brain

Journal Article Southern African Journal of Anaesthesia and Analgesia · January 1, 2008 The brain is often a window to early changes in blood flow, tissue perfusion, or early neural damage manifested by a decline in higher cortical functions including recall memory and cognitive processing. The elderly population is particularly at risk of ce ... Full text Cite

Intraoperative hyperglycemia and cognitive decline after CABG.

Journal Article Ann Thorac Surg · November 2007 BACKGROUND: Neurocognitive dysfunction (NCD) continues to occur in a significant number of patients after cardiac procedures. The factors influencing its incidence and severity are not completely known. We hypothesized that hyperglycemia, which is known to ... Full text Link to item Cite

Deterioration of regional wall motion immediately after coronary artery bypass graft surgery is associated with long-term major adverse cardiac events.

Journal Article Anesthesiology · November 2007 BACKGROUND: Patients undergoing coronary artery bypass graft (CABG) surgery frequently develop wall motion abnormalities diagnosed by intraoperative transesophageal echocardiography. However, the relation between deterioration in wall motion and postoperat ... Full text Link to item Cite

Clevidipine effectively and rapidly controls blood pressure preoperatively in cardiac surgery patients: the results of the randomized, placebo-controlled efficacy study of clevidipine assessing its preoperative antihypertensive effect in cardiac surgery-1.

Journal Article Anesth Analg · October 2007 BACKGROUND: Clevidipine is an ultrashort-acting, third-generation IV dihydropyridine calcium channel blocker that exerts rapid and titratable arterial blood pressure reduction, with fast termination of effect due to metabolism by blood and tissue esterases ... Full text Link to item Cite

Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.

Journal Article Anesthesiology · October 2007 BACKGROUND: Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery pa ... Full text Link to item Cite

Genetic variants in P-selectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery.

Journal Article J Am Coll Cardiol · May 15, 2007 OBJECTIVES: We hypothesized that candidate gene polymorphisms in biologic pathways regulating inflammation, cell matrix adhesion/interaction, coagulation-thrombosis, lipid metabolism, and vascular reactivity are associated with postoperative cognitive defi ... Full text Link to item Cite

Cytokine secretion after cardiac surgery and its relationship to postoperative fever.

Journal Article Cytokine · April 2007 A relationship between the inflammatory response to cardiopulmonary bypass (CPB) and fever after coronary artery bypass graft surgery (CABG) is assumed, but has not been studied. Therefore, we sought to assess the temporal pattern of cytokines' elevation a ... Full text Link to item Cite

A phase II, double-blind, placebo-controlled, ascending-dose study of Eritoran (E5564), a lipid A antagonist, in patients undergoing cardiac surgery with cardiopulmonary bypass.

Journal Article Anesth Analg · February 2007 BACKGROUND: Lipid A, the toxic moiety of endotoxin, is linked to multiple complications after cardiac surgery, including fever, vasodilation, and pulmonary and renal dysfunction. The lipid A antagonist eritoran (or E5564) prevents endotoxin-induced systemi ... Full text Link to item Cite

Open heart surgery and cognitive decline.

Journal Article Cleve Clin J Med · February 2007 Full text Link to item Cite

Donepezil for cognitive decline following coronary artery bypass surgery: a pilot randomized controlled trial.

Journal Article Psychopharmacol Bull · 2007 OBJECTIVE: To study the effect of donepezil in treating patients with cognitive decline following coronary artery bypass graft (CABG) surgery. METHODS: Forty-four patients, with at least a 0.5 SD decline at 1 year post-CABG on at least one cognitive domain ... Link to item Cite

Central nervous system injury associated with cardiac surgery.

Journal Article Lancet · August 19, 2006 Millions of individuals with coronary artery or valvular heart disease have been given a new chance at life by heart surgery, but the potential for neurological injury is an Achilles heel. Technological advancements and innovations in surgical and anaesthe ... Full text Link to item Cite

Pexelizumab reduces death and myocardial infarction in higher risk cardiac surgical patients.

Journal Article Ann Thorac Surg · August 2006 BACKGROUND: Morbidity and mortality after coronary artery bypass graft surgery are directly related to specific preoperative risk factors. We assessed the influence of preoperative risk factors on the effect of pexelizumab, a C5 complement inhibitor, to re ... Full text Link to item Cite

Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery.

Journal Article Circulation · July 4, 2006 BACKGROUND: The inflammatory response triggered by cardiac surgery with cardiopulmonary bypass (CPB) is a primary mechanism in the pathogenesis of postoperative myocardial infarction (PMI), a multifactorial disorder with significant inter-patient variabili ... Full text Link to item Cite

Effects of decreased preoperative endotoxin core antibody levels on long-term mortality after coronary artery bypass graft surgery.

Journal Article Arch Surg · July 2006 HYPOTHESIS: Decreased preoperative levels of antiendotoxin core antibody (EndoCAb) in patients undergoing cardiac surgery with cardiopulmonary bypass are associated with increased long-term mortality. DESIGN: Observational study. SETTING: Academic medical ... Full text Link to item Cite

Transcerebral platelet activation after aortic cross-clamp release is linked to neurocognitive decline.

Journal Article Ann Thorac Surg · May 2006 BACKGROUND: Neurocognitive decline after cardiac surgery requiring cardiopulmonary bypass (CPB) may be caused in part by highly prothrombotic atheroemboli to the brain; the source of these emboli is likely the ascending aorta and aortic arch. We examined t ... Full text Link to item Cite

Efficacy of single-dose, multilevel paravertebral nerve blockade for analgesia after thoracoscopic procedures.

Journal Article Anesthesiology · May 2006 BACKGROUND: Although video-assisted thoracoscopic surgery for pulmonary resection is increasingly chosen over thoracotomy, the optimal analgesia regimen for thoracoscopy is unknown. The purpose of this trial was to compare the efficacy of analgesia from pr ... Full text Link to item Cite

Inhibition of complement activation by pexelizumab reduces death in patients undergoing combined aortic valve replacement and coronary artery bypass surgery.

Journal Article J Thorac Cardiovasc Surg · February 2006 OBJECTIVE: We sought to evaluate the effects of pexelizumab, a C5 complement inhibitor, on death and myocardial infarction in patients undergoing combined aortic valve replacement and coronary artery bypass grafting surgery. METHODS: The Pexelizumab for Re ... Full text Link to item Cite

Association of neurocognitive function and quality of life 1 year after coronary artery bypass graft (CABG) surgery.

Journal Article Psychosom Med · 2006 OBJECTIVE: Although coronary artery bypass grafting (CABG) has been shown to improve quality of life and functional capacity for many patients, recent studies have demonstrated that a significant number of patients exhibit impairment in cognitive function ... Full text Link to item Cite

The use of high-fidelity human patient simulation as an evaluative tool in the development of clinical research protocols and procedures.

Journal Article Contemp Clin Trials · December 2005 Errors in clinical research can be costly, in terms of patient safety, data integrity, and data collection. Data inaccuracy in early subjects of a clinical study may be associated with problems in the design of the protocol, procedures, and data collection ... Full text Link to item Cite

APOE polymorphism is associated with risk of severe sepsis in surgical patients.

Journal Article Crit Care Med · November 2005 OBJECTIVE: To test for an association between apolipoprotein E (APOE) genotypes and the occurrence of severe sepsis in an elective surgical cohort. DESIGN: Prospective, observational, single cohort study. SETTING: Sixteen-bed surgical intensive care unit ( ... Full text Link to item Cite

Efficacy of zoniporide, an Na/H exchange ion inhibitor, for reducing perioperative cardiovascular events in vascular surgery patients.

Journal Article J Cardiothorac Vasc Anesth · October 2005 OBJECTIVES: To determine whether a novel Na+/H+ exchange ion inhibitor, zoniporide, is associated with reduced perioperative myocardial ischemic injury in high-risk surgery patients. DESIGN: Randomized double-blind placebo-controlled multidose trial. SETTI ... Full text Link to item Cite

Cerebral physiology of cardiac surgical patients treated with the perfluorocarbon emulsion, AF0144.

Journal Article Ann Thorac Surg · October 2005 BACKGROUND: Perfluorooctyl bromide is a biologically inert compound with short biologic retention and high oxygen solubility. The purpose of this study was to assess the effect of the perfluorocarbon emulsion, AF0144 (Perflubron, Alliance Pharmaceutical Co ... Full text Link to item Cite

Genetic polymorphisms and the risk of stroke after cardiac surgery.

Journal Article Stroke · September 2005 BACKGROUND AND PURPOSE: Stroke represents a significant cause of morbidity and mortality after cardiac surgery. Although the risk of stroke varies according to both patient and procedural factors, the impact of genetic variants on stroke risk is not well u ... Full text Link to item Cite

Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass surgery.

Journal Article J Cardiothorac Vasc Anesth · August 2005 OBJECTIVE: Hyperthermia is common in the first 24 hours following coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). An inflammatory response to CPB is often implicated in the pathophysiology of this fever. Unlike CABG with CPB, ... Full text Link to item Cite

Efficacy and safety of heparinase I versus protamine in patients undergoing coronary artery bypass grafting with and without cardiopulmonary bypass.

Journal Article Anesthesiology · August 2005 BACKGROUND: Hemodynamic protamine reactions with heparin reversal during cardiac surgery are common and associated with adverse outcomes. As an alternative to protamine, the authors examined heparinase I reversal of heparin after aortocoronary bypass graft ... Full text Link to item Cite

Genetic factors contribute to bleeding after cardiac surgery.

Journal Article J Thromb Haemost · June 2005 BACKGROUND: Postoperative bleeding remains a common, serious problem for cardiac surgery patients, with striking inter-patient variability poorly explained by clinical, procedural, and biological markers. OBJECTIVE: We tested the hypothesis that genetic po ... Full text Link to item Cite

Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · June 2005 OBJECTIVE: The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory respo ... Full text Link to item Cite

Foreward

Journal Article Middle East Journal of Anesthesiology · June 1, 2005 Cite

Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery.

Journal Article Am J Kidney Dis · March 2005 BACKGROUND: Post-cardiac surgery renal dysfunction is a common, serious, multifactorial disorder, with interpatient variability predicted poorly by preoperative clinical, procedural, and biological markers. Therefore, we tested the hypothesis that selected ... Full text Link to item Cite

Novel human alpha1a-adrenoceptor single nucleotide polymorphisms alter receptor pharmacology and biological function.

Journal Article Naunyn Schmiedebergs Arch Pharmacol · March 2005 We identified nine naturally-occurring human single nucleotide polymorphisms (SNPs) in the alpha(1a)-adrenoceptor (alpha(1a)AR) coding region, seven of which result in amino acid change. Utilizing rat-1 fibroblasts stably expressing wild type alpha(1a)AR o ... Full text Link to item Cite

Hemodynamic changes after protamine administration: association with mortality after coronary artery bypass surgery.

Journal Article Anesthesiology · February 2005 BACKGROUND: Protamine sulfate is standard therapy to reverse heparin anticoagulation. Hemodynamic responses to protamine are common, ranging from minor perturbations to cardiovascular collapse. Although severe fatal reactions occur, the relation of less ex ... Full text Link to item Cite

Brief report: The declining incidence of cerebral hyperthermia during cardiac surgery: a seven-year experience in 6,334 patients.

Journal Article Can J Anaesth · 2005 PURPOSE: Cerebral hyperthermia during rewarming from hypothermic cardiopulmonary bypass (CPB) commonly occurs and has been associated with postoperative neurocognitive dysfunction. Increased awareness of this has likely led to changes in rewarming strategi ... Full text Link to item Cite

Renal artery stenosis is not associated with the development of acute renal failure following coronary artery bypass grafting.

Journal Article Ren Fail · 2005 BACKGROUND: Acute renal failure (ARF) is a frequent complication of coronary artery bypass grafting (CABG) surgery and is strongly associated with perioperative morbidity and mortality. We hypothesized that renal artery stenosis (RAS), causing occult renal ... Link to item Cite

Fixing the heart: must the brain pay the price?

Journal Article Circulation · November 30, 2004 Full text Link to item Cite

Preliminary report of the effects of complement suppression with pexelizumab on neurocognitive decline after coronary artery bypass graft surgery.

Journal Article Stroke · October 2004 BACKGROUND AND PURPOSE: Pharmacological modulation of complement activation recently has been postulated as a therapeutic target in the treatment of neurological injury. We hypothesized that pexelizumab, a humanized scFv monoclonal antibody directed agains ... Full text Link to item Cite

Transcranial Doppler emboli count predicts rise in creatinine after coronary artery bypass graft surgery.

Journal Article J Cardiothorac Vasc Anesth · October 2004 OBJECTIVE: To examine the correlation between transcranial Doppler ultrasonography-detected emboli during coronary artery bypass graft surgery with cardiopulmonary bypass and renal dysfunction as determined by the postoperative change in creatinine. DESIGN ... Full text Link to item Cite

Prevention of cerebral hyperthermia during cardiac surgery by limiting on-bypass rewarming in combination with post-bypass body surface warming: a feasibility study.

Journal Article Anesth Analg · September 2004 Cerebral hyperthermia is common during the rewarming phase of cardiopulmonary bypass (CPB) and is implicated in CPB-associated neurocognitive dysfunction. Limiting rewarming may prevent cerebral hyperthermia but risks postoperative hypothermia. In a prospe ... Full text Link to item Cite

Preliminary report on the interaction of apolipoprotein E polymorphism with aortic atherosclerosis and acute nephropathy after CABG.

Journal Article Ann Thorac Surg · August 2004 BACKGROUND: Renal dysfunction is a serious complication of cardiac surgery that is highly associated with short- and long-term adverse outcome. While the apolipoprotein E (APOE) epsilon4 allele has been linked to the occurrence of both postcardiac surgery ... Full text Link to item Cite

Preliminary report on the use of high-fidelity simulation in the training of study coordinators conducting a clinical research protocol.

Journal Article Anesth Analg · August 2004 Training of health care research personnel is a critical component of quality assurance in clinical trials. Interactivity (such as simulation) is desirable compared with traditional methods of teaching. We hypothesized that the addition of an interactive s ... Full text Link to item Cite

Predictors of inotrope use during separation from cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · August 2004 OBJECTIVE: To identify the demographic, clinical, and echocardiographic features that predict the use of inotropic support at separation from cardiopulmonary bypass (CPB). DESIGN: Retrospective study of consecutive patients undergoing coronary artery bypas ... Full text Link to item Cite

Terminal complement blockade with pexelizumab during coronary artery bypass graft surgery requiring cardiopulmonary bypass: a randomized trial.

Journal Article JAMA · May 19, 2004 CONTEXT: Inflammation and ischemia-reperfusion injury during coronary artery bypass graft (CABG) surgery requiring cardiopulmonary bypass are associated with postoperative myocardial infarction (MI) and mortality. OBJECTIVE: To determine the efficacy and s ... Full text Link to item Cite

Metoprolol and coronary artery bypass grafting surgery: does intraoperative metoprolol attenuate acute beta-adrenergic receptor desensitization during cardiac surgery?

Journal Article Anesth Analg · May 2004 UNLABELLED: Cardiac surgery results in significant impairment of beta-adrenergic receptor (beta AR) function and is a cause of depressed myocardial function after surgery. We previously demonstrated that acute administration of beta AR blocker during cardi ... Full text Link to item Cite

Periventricular leukomalacia is common after neonatal cardiac surgery.

Journal Article J Thorac Cardiovasc Surg · March 2004 OBJECTIVES: Periventricular leukomalacia is necrosis of the cerebral white matter adjacent to the lateral ventricles and results from injury to immature oligodendroglia. In infants without congenital heart disease, periventricular leukomalacia is associate ... Full text Link to item Cite

The association of patent foramen ovale and atrial fibrillation after coronary artery bypass graft surgery.

Journal Article Anesth Analg · March 2004 UNLABELLED: Atrial fibrillation (AF) is associated with considerable morbidity and increased resource utilization after coronary artery bypass graft surgery. In this study, we sought to determine whether patent foramen ovale (PFO) and atrial septal aneurys ... Full text Link to item Cite

Economic impact of drug-eluting stents on hospital systems: a disease-state model.

Journal Article Am Heart J · March 2004 BACKGROUND: Drug-eluting intracoronary stents decrease restenosis and later revascularization. The US Department of Health and Human Services (HHS), recognizing the financial and clinical impact of this technology, recently proposed accelerated reimburseme ... Full text Link to item Cite

A randomized controlled trial of the Arctic Sun Temperature Management System versus conventional methods for preventing hypothermia during off-pump cardiac surgery.

Journal Article Anesth Analg · February 2004 UNLABELLED: In this trial we compared the hypothermia avoidance abilities of the Arctic Sun Temperature Management System (a servo-regulated system that circulates temperature-controlled water through unique energy transfer pads adherent to the patient's b ... Full text Link to item Cite

Cardiopulmonary bypass and the brain

Chapter · January 1, 2004 The utilization of cardiopulmonary bypass to allow surgery on the heart was first described in the middle part of the last century (Dennis et al., 1951; Gibbon, 1954). Since that time, considerable advancements have been made not only in our understanding ... Cite

Novel diagnostic test for acute stroke.

Journal Article Stroke · January 2004 BACKGROUND AND PURPOSE: The absence of a widely available and sensitive diagnostic test for acute cerebral ischemia remains a significant limitation in the diagnosis and management of stroke. The objective of this study was to examine the feasibility of de ... Full text Link to item Cite

Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment.

Journal Article Psychosom Med · 2004 OBJECTIVE: The present paper reviews the evidence that depression is a risk factor for the development and progression of coronary artery disease (CAD). METHODS: MEDLINE searches and reviews of bibliographies were used to identify relevant articles. Articl ... Full text Link to item Cite

Cerebral embolization during cardiac surgery: impact of aortic atheroma burden.

Other Br J Anaesth · November 2003 BACKGROUND: Aortic atheromatous disease is known to be associated with an increased risk of perioperative stroke in the setting of cardiac surgery. In this study, we sought to determine the relationship between cerebral microemboli and aortic atheroma burd ... Full text Link to item Cite

Age increases expression and receptor-mediated activation of G alpha i in human atria.

Journal Article J Cardiovasc Pharmacol · November 2003 Recently, we demonstrated that beta2AR and several other Galphas-coupled receptors in human atria also couple to Galphai, a G protein that inhibits adenylyl cyclase (AC). The present study was undertaken to determine whether age increases expression of Gal ... Full text Link to item Cite

Home surveillance program prevents interstage mortality after the Norwood procedure.

Journal Article J Thorac Cardiovasc Surg · November 2003 OBJECTIVE: To determine whether early identification of physiologic variances associated with interstage death would reduce mortality, we developed a home surveillance program. METHODS: Patients discharged before initiation of home surveillance (group A, n ... Full text Link to item Cite

The association of lowest hematocrit during cardiopulmonary bypass with acute renal injury after coronary artery bypass surgery.

Journal Article Ann Thorac Surg · September 2003 BACKGROUND: Acute renal injury is a common serious complication of cardiac surgery. Moderate hemodilution is thought to reduce the risk of kidney injury but the current practice of extreme hemodilution (target hematocrit 22% to 24%) during cardiopulmonary ... Full text Link to item Cite

Depression as a risk factor for mortality after coronary artery bypass surgery.

Journal Article Lancet · August 23, 2003 BACKGROUND: Studies that have shown clinical depression to be a risk factor for cardiac events after coronary artery bypass graft (CABG) surgery have had small sample sizes, short follow-up, and have not had adequate power to assess mortality. We sought to ... Full text Link to item Cite

Low serum magnesium level predicts major adverse cardiac events after coronary artery bypass graft surgery.

Journal Article Am Heart J · June 2003 BACKGROUND: Despite improved myocardial protection strategies and enhanced surgical techniques, mortality after coronary artery bypass graft surgery (CABG) remains essentially unchanged. This may be because of the increasing age of patients who undergo pri ... Full text Link to item Cite

Chronic exposure to nicotine does not prevent neurocognitive decline after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2003 OBJECTIVE: To establish the association between smoking and cognitive decline in patients undergoing coronary artery bypass graft (CABG) surgery. DESIGN: Retrospective review. SETTING: Referral center for cardiothoracic surgery at a university hospital. PA ... Full text Link to item Cite

Preliminary evaluation of the Arctic Sun temperature-controlling system during off-pump coronary artery bypass surgery.

Journal Article Ann Thorac Surg · April 2003 BACKGROUND: Maintaining normothermia during off-pump coronary artery bypass (OPCAB) surgery is a challenge not met by currently available medical devices and strategies. The purpose of this study was to determine the efficacy of a new thermoregulatory devi ... Full text Link to item Cite

Postcardiac surgery complications: association of acute renal dysfunction and atrial fibrillation.

Journal Article Anesth Analg · March 2003 UNLABELLED: Postoperative creatinine increase is associated with adverse outcome after cardiac surgery. Although postoperative stroke and renal dysfunction are associated after cardiac surgery, suggesting a common systemic insult, a similar assessment of a ... Full text Link to item Cite

Cardiopulmonary bypass decreases G protein-coupled receptor kinase activity and expression in human peripheral blood mononuclear cells.

Journal Article Anesthesiology · February 2003 BACKGROUND: Cardiopulmonary bypass (CPB) has been implicated in the development of organ injury associated with cardiac surgery. At the molecular level, CPB is accompanied by a pronounced proinflammatory response including an increase in plasma interleukin ... Full text Link to item Cite

Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery.

Journal Article Stroke · February 2003 BACKGROUND AND PURPOSE: Although coronary artery bypass graft surgery (CABG) improves the quality of life and functional capacity for numerous patients, many also exhibit impairment in cognitive function immediately after surgery. Although the etiology of ... Full text Link to item Cite

Neurologic outcomes after coronary artery bypass grafting with and without cardiopulmonary bypass.

Journal Article Semin Thorac Cardiovasc Surg · January 2003 Neurologic injury, in the form of either stroke or more subtle neurocognitive impairment, is a frequent and potentially devastating complication of coronary artery bypass grafting (CABG). The etiology of CABG-associated neurologic injury is likely multifac ... Full text Link to item Cite

Female gender is associated with impaired quality of life 1 year after coronary artery bypass surgery.

Journal Article Psychosom Med · 2003 OBJECTIVE: To evaluate gender-related differences in quality of life (QOL) and cognitive function 1 year after coronary artery bypass surgery (CABG) after adjusting for known baseline differences. MATERIALS AND METHODS: Two hundred eighty patients (96 wome ... Full text Link to item Cite

Perflubron emulsion (AF0144) augments harvesting of autologous blood: a phase II study in cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · October 2002 OBJECTIVE: To assess tolerance and preliminary efficacy of a perfluorocarbon emulsion (AF0144) used with acute normovolemic hemodilution to reduce allogeneic blood transfusion for patients undergoing coronary artery bypass graft (CABG) surgery with cardiop ... Full text Link to item Cite

Change in plasma glutamate concentration during cardiac surgery is a poor predictor of cognitive outcome.

Journal Article J Cardiothorac Vasc Anesth · August 2002 OBJECTIVE: To develop a simple and reliable method for quantitating plasma glutamate concentration and apply this method to monitor systemic glutamate levels during coronary artery bypass graft (CABG) surgery, a procedure associated with neurologic deficit ... Full text Link to item Cite

Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy (a 25-year experience from the Duke Cardiovascular Disease Databank).

Journal Article Am J Cardiol · July 15, 2002 In this observational treatment comparison in a single center over 25 years, we sought to assess long-term outcomes of coronary artery bypass surgery (CABG) or medical therapy in patients with heart failure, coronary artery disease, and left ventricular sy ... Full text Link to item Cite

Serum creatinine patterns in coronary bypass surgery patients with and without postoperative cognitive dysfunction.

Other Anesth Analg · July 2002 UNLABELLED: Renal dysfunction is common after coronary artery bypass graft (CABG) surgery. We have previously shown that CABG procedures complicated by stroke have a threefold greater peak serum creatinine level relative to uncomplicated surgery. However, ... Full text Link to item Cite

Neuroprotection is associated with beta-adrenergic receptor antagonists during cardiac surgery: evidence from 2,575 patients.

Journal Article J Cardiothorac Vasc Anesth · June 2002 OBJECTIVE: To determine the impact of perioperative beta-adrenergic receptor (betaAR) antagonist administration on neurologic complications. DESIGN: Observational database analysis. SETTING: A clinical investigation at a single tertiary academic medical ce ... Full text Link to item Cite

Differential cerebral gene expression during cardiopulmonary bypass in the rat: evidence for apoptosis?

Journal Article Anesth Analg · June 2002 UNLABELLED: Cardiopulmonary bypass (CPB) is associated with a spectrum of cerebral injuries. The molecular changes in the brain that might contribute to these injuries are not clearly known. We sought to determine whether the expression of apoptotic genes ... Full text Link to item Cite

The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass.

Journal Article Anesth Analg · May 2002 UNLABELLED: Outcome after cardiac surgery varies depending on complication type. We therefore sought to determine the association between complication type, mortality, and length of stay in a large series of patients undergoing cardiac surgery with cardiop ... Full text Link to item Cite

Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery.

Journal Article Stroke · February 2002 BACKGROUND AND PURPOSE: Temperature is a well-known modulator of experimental cerebral injury. We hypothesized that hyperthermia would be associated with a worsened cognitive outcome after coronary artery bypass graft surgery (CABG). METHODS: Three hundred ... Full text Link to item Cite

The impact of postoperative atrial fibrillation on neurocognitive outcome after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 2002 UNLABELLED: Neurocognitive decline is a continuing source of morbidity after cardiac surgery. Atrial fibrillation occurs often after cardiac surgery and has been linked to adverse neurologic events. We sought to determine whether postoperative atrial fibri ... Full text Link to item Cite

Association of leukocyte-depleted blood transfusions with infectious complications after cardiac surgery.

Journal Article Surg Infect (Larchmt) · 2002 BACKGROUND: To test the hypothesis that leukocyte-mediated immunosuppression may contribute to postoperative infections after blood transfusions, we compared the incidence of postoperative infections in patients undergoing elective coronary artery bypass g ... Full text Link to item Cite

The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery.

Other Anesth Analg · January 2002 UNLABELLED: Neurocognitive dysfunction is a common complication after cardiac surgery. We evaluated in this prospective study the effect of rewarming rate on neurocognitive outcome after hypothermic cardiopulmonary bypass (CPB). After IRB approval and info ... Full text Link to item Cite

Cardiopulmonary bypass induces neurologic and neurocognitive dysfunction in the rat.

Journal Article Anesthesiology · December 2001 BACKGROUND: Neurocognitive dysfunction is a common complication of cardiac surgery using cardiopulmonary bypass (CPB). Elucidating injury mechanisms and developing neuroprotective strategies have been hampered by the lack of a suitable long-term recovery m ... Full text Link to item Cite

Report of the substudy assessing the impact of neurocognitive function on quality of life 5 years after cardiac surgery.

Journal Article Stroke · December 1, 2001 BACKGROUND AND PURPOSE: The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some ... Full text Link to item Cite

Report of a substudy on warm versus cold cardiopulmonary bypass: changes in creatinine clearance.

Journal Article Ann Thorac Surg · November 2001 BACKGROUND: Renal dysfunction remains a major complication of cardiac operations. There is concern regarding the possibility of increased renal injury during warm cardiopulmonary bypass (CPB). Therefore, we tested the hypothesis that warm CPB is associated ... Full text Link to item Cite

Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery.

Journal Article Anesthesiology · November 2001 BACKGROUND: Despite significant advances in cardiopulmonary bypass (CPB) technology, surgical techniques, and anesthetic management, central nervous system complications occur in a large percentage of patients undergoing surgery requiring CPB. Many centers ... Full text Link to item Cite

Effect of apolipoprotein E genotype on cerebral autoregulation during cardiopulmonary bypass.

Journal Article Stroke · July 2001 BACKGROUND AND PURPOSE: The presence of the apolipoprotein E epsilon4 (apoE4) allele has been associated with cognitive decline after cardiac surgery. We compared autoregulation of cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMRO(2)), an ... Full text Link to item Cite

A randomized double-blinded multicenter comparison of remifentanil versus fentanyl when combined with isoflurane/propofol for early extubation in coronary artery bypass graft surgery.

Journal Article Anesth Analg · May 2001 UNLABELLED: We compared a fentanyl/isoflurane/propofol regimen with a remifentanil/isoflurane/propofol regimen for fast-track cardiac anesthesia in a prospective, randomized, double-blinded study on patients undergoing elective coronary artery bypass graft ... Full text Link to item Cite

The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery: a prospective randomized, double-blinded controlled, multi-center trial.

Journal Article Anesth Analg · May 2001 UNLABELLED: We compared (a) the perioperative complications; (b) times to eligibility for, and actual time of the following: extubation, less intense monitoring, intensive care unit (ICU), and hospital discharge; and (c) resource utilization of nursing rat ... Full text Link to item Cite

Apolipoprotein E polymorphisms and age at first coronary artery bypass graft.

Journal Article Anesth Analg · April 2001 UNLABELLED: Apolipoprotein E (apoE) polymorphisms are heritable determinants of total and low-density lipoprotein cholesterol. The impact of apoE4 genotypes on the severity of atherosclerosis has been debated; however, recent studies have identified a corr ... Full text Link to item Cite

Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery.

Journal Article N Engl J Med · February 8, 2001 BACKGROUND: Cognitive decline complicates early recovery after coronary-artery bypass grafting (CABG) and may be evident in as many as three quarters of patients at the time of discharge from the hospital and a third of patients after six months. We sought ... Full text Link to item Cite

Platelet PlA2 polymorphism enhances risk of neurocognitive decline after cardiopulmonary bypass. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Journal Article Ann Thorac Surg · February 2001 BACKGROUND: Neurocognitive decline, often produced by atherosclerotic plaque embolization, remains a frequent complication of cardiopulmonary bypass. Plaque fragments may initiate local thrombosis, which, in turn, aggravates the embolic insult. Prothrombot ... Full text Link to item Cite

Neurological injury during cardiopulmonary bypass in the rat.

Journal Article Perfusion · January 2001 Cerebral injury is a well-known complication of cardiac surgery. Investigations of both injury mechanisms and neuroprotective strategies have partially been limited by the lack of an adequate preclinical model of small animal cardiopulmonary bypass (CPB). ... Full text Link to item Cite

Temperature during coronary artery bypass surgery affects quality of life.

Journal Article Ann Thorac Surg · January 2001 BACKGROUND: The objective of this study was to examine the effects of temperature on a variety of indices of psychologic adjustment and quality of life. METHODS: A total of 209 patients randomly received normothermic (warm) or hypothermic (cold) conditions ... Full text Link to item Cite

Genetic predictors of perioperative neurological and cognitive injury and recovery

Journal Article Best Practice and Research: Clinical Anaesthesiology · January 1, 2001 In most investigations, genetic and environmental factors have been shown to interact in altering the progression of ageing related disease including stroke and cognitive decline. The perioperative period appears to be no different, with environmental (ope ... Full text Cite

Off-pump versus on-pump coronary artery bypass surgery and postoperative renal dysfunction.

Journal Article Anesth Analg · November 2000 UNLABELLED: Renal dysfunction is a serious complication after coronary bypass surgery with cardiopulmonary bypass (CABG). Because duration of cardiopulmonary bypass (CPB) is associated with renal outcome, it has been proposed that avoidance of CPB with off ... Full text Link to item Cite

The association of epsilon-aminocaproic acid with postoperative decrease in creatinine clearance in 1502 coronary bypass patients.

Journal Article Anesth Analg · November 2000 UNLABELLED: Renal dysfunction is a common serious complication after cardiac surgery. Reports of proteinuria and hyperkalemia after cardiac surgery with epsilon-aminocaproic acid (EACA) have therefore raised concerns for renal safety. Since EACA renders th ... Full text Link to item Cite

Beta(2)-adrenergic and several other G protein-coupled receptors in human atrial membranes activate both G(s) and G(i).

Journal Article Circ Res · October 13, 2000 Cardiac G protein-coupled receptors that couple to Galpha(s) and stimulate cAMP formation (eg, beta-adrenergic, histamine, serotonin, and glucagon receptors) play a key role in cardiac inotropy. Recent studies in rodent cardiac myocytes and transfected cel ... Full text Link to item Cite

Preliminary report on the association of apolipoprotein E polymorphisms, with postoperative peak serum creatinine concentrations in cardiac surgical patients.

Journal Article Anesthesiology · August 2000 BACKGROUND: Renal dysfunction after cardiac surgery occurs in up to 8% of patients and is associated with major increases in morbidity, mortality, and cost. Genetic polymorphisms have been implicated as a factor in the progression of chronic renal disease, ... Full text Link to item Cite

Intraoperative physiologic variables and outcome in cardiac surgery: Part I. In-hospital mortality.

Journal Article Ann Thorac Surg · April 2000 BACKGROUND: Risk stratification schemes have been developed to predict outcome of coronary artery bypass grafting (CABG) procedures, which are predominately based upon unalterable preoperative patient characteristics. The purpose of this study was to deter ... Full text Link to item Cite

Intraoperative physiologic variables and outcome in cardiac surgery: Part II. Neurologic outcome.

Journal Article Ann Thorac Surg · April 2000 BACKGROUND: The impact of alterable physiologic variables on neurologic outcome after coronary artery bypass grafting procedures is unknown. The purpose of this study was to determine whether minimum intraoperative hematocrit, maximum glucose concentration ... Full text Link to item Cite

Central nervous system complications of cardiac surgery.

Journal Article Br J Anaesth · March 2000 The neurological complications of cardiac surgery are associated with significantly increased mortality, morbidity and resource utilization. The use of new surgical techniques, introduction of wider indications for surgery and increased public expectation ... Full text Link to item Cite

β2-Adrenergic and several other g protein-coupled receptors in human atrial membranes activate both G(s) and G(i)

Journal Article Circulation Research · 2000 Cardiac G protein-coupled receptors that couple to Gα(s) and stimulate cAMP formation (eg, β-adrenergic, histamine, serotonin, and glucagon receptors) play a key role in cardiac inotropy. Recent studies in rodent cardiac myocytes and transfected cells have ... Cite

Strategies to protect the brain during cardiac surgery

Journal Article Seminars in Cardiothoracic and Vascular Anesthesia · January 1, 2000 Despite significant advances in cardiopulmonary bypass (CPB) technology, surgical techniques, and anesthetic management, central nervous system (CNS) complications remain a common and costly problem after CPB. Stroke is often considered a rare and unpreven ... Full text Cite

Central nervous system complications of cardiac surgery

Journal Article Cahiers d'Anesthesiologie · January 1, 2000 Cite

Neurologic risk assessment, monitoring and outcome in cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · December 1999 Full text Link to item Cite

Direct aortic cannulation for port-access mitral or coronary artery bypass grafting.

Journal Article Ann Thorac Surg · November 1999 A technique is described for direct aortic arterial cannulation during Port-Access mitral valve or coronary artery bypass grafting. Femoral arterial cannulation is avoided, and endoaortic balloon occlusion is used for cardioplegic arrest. To date, excellen ... Full text Link to item Cite

Cognitive decline after major noncardiac operations: a preliminary prospective study.

Journal Article Ann Thorac Surg · November 1999 BACKGROUND: Cardiac operations frequently are complicated by postoperative cognitive decline. Less common and less studied is postoperative cognitive decline after noncardiac surgery, so we determined its incidence, severity, and possible predictors. METHO ... Full text Link to item Cite

The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery.

Journal Article Anesth Analg · August 1999 UNLABELLED: Vital healthcare resources are devoted to caring for patients with prolonged hospitalization after routine, moderate-risk surgery. Despite the significant cost, little is known about the overall incidence and pattern of complications in these p ... Full text Link to item Cite

Acute renal failure following cardiac surgery.

Journal Article Nephrol Dial Transplant · May 1999 BACKGROUND: Acute renal failure requiring dialysis (ARF-D) occurs in 1.5% of patients following cardiac surgery, and remains a cause of major morbidity and mortality. While some preoperative risk factors have been characterized, the influence of preoperati ... Full text Link to item Cite

Ineffectiveness of burst suppression therapy in mitigating perioperative cerebrovascular dysfunction. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Journal Article Anesthesiology · May 1999 BACKGROUND: Cerebral injury is among the most common and disabling complications of open heart surgery. Attempts to provide neuroprotection have yielded conflicting results. We assessed the potential of propofol-induced burst suppression during open heart ... Full text Link to item Cite

Epsilon-aminocaproic acid administration and stroke following coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · May 1999 BACKGROUND: Epsilon-aminocaproic acid is routinely used to reduce bleeding during cardiac surgery. Anecdotal reports of thrombotic complications have led to speculation regarding this drug's safety. We investigated the association between epsilon-aminocapr ... Full text Link to item Cite

Perception of cognitive function in older adults following coronary artery bypass surgery.

Journal Article Health Psychol · May 1999 This study examined the effects of coronary artery bypass grafting (CABG) on objective and subjective measures of neurocognitive functioning. Participants were 170 older patients (127 men and 43 women; mean age = 61 years) undergoing CABG. Measures of neur ... Full text Link to item Cite

Cerebral injury after cardiac surgery: identification of a group at extraordinary risk. Multicenter Study of Perioperative Ischemia Research Group (McSPI) and the Ischemia Research Education Foundation (IREF) Investigators.

Journal Article Stroke · March 1999 BACKGROUND AND PURPOSE: Cerebral injury after cardiac surgery is now recognized as a serious and costly healthcare problem mandating immediate attention. To effect solution, those subgroups of patients at greatest risk must be identified, thereby allowing ... Full text Link to item Cite

Genetic predictors of perioperative neurologic and neuropsychological injury and recovery

Journal Article Seminars in Cardiothoracic and Vascular Anesthesia · January 1, 1999 Central nervous system (CNS) dysfunction after cardiopulmonary bypass represents a continuum from coma and focal stroke to cognitive deficits after surgery. Despite the marked increase in investigation of neurologic and neurocognitive deficits after cardia ... Full text Cite

Temperature measurement during cardiac surgery.

Journal Article Can J Anaesth · November 1998 Full text Link to item Cite

Balance of proinflammatory and antiinflammatory cytokines at thoracic cancer operation.

Journal Article Ann Thorac Surg · October 1998 BACKGROUND: A homeostatic balance of proinflammatory and antiinflammatory cytokines is thought to be important for the maintenance of health. Cytokine baseline levels and response patterns to cardiac and nonmalignant abdominal operations have been investig ... Full text Link to item Cite

Cerebral emboli and serum S100beta during cardiac operations.

Journal Article Ann Thorac Surg · June 1998 BACKGROUND: The glial protein S100beta has been used to estimate cerebral damage in a number of clinical settings. The purpose of this investigation was to determine the correlation between cerebral microemboli and S100beta levels during cardiac operations ... Full text Link to item Cite

Cardiopulmonary bypass time does not affect cerebral blood flow.

Journal Article Ann Thorac Surg · May 1998 BACKGROUND: A time-dependent decline in cerebral blood flow (CBF) has been reported in cardiac surgical patients despite stable pump flows and arterial carbon dioxide tension. Other studies have failed to support these hypothermic cardiopulmonary bypass (C ... Full text Link to item Cite

Pharmacologic electroencephalographic suppression during cardiopulmonary bypass: a comparison of thiopental and isoflurane.

Journal Article Anesth Analg · February 1998 UNLABELLED: In this study, we examined the cerebral oxygenation effects of two methods of pharmacologic burst suppression during cardiopulmonary bypass (CPB) in valvular heart surgery patients. Patients were randomly entered into one of three groups: contr ... Full text Link to item Cite

Transcranial Doppler blood flow velocity versus 133Xe clearance cerebral blood flow during mild hypothermic cardiopulmonary bypass.

Journal Article J Clin Monit Comput · January 1998 OBJECTIVE: Transcranial doppler (TCD) is used during cardiopulmonary bypass (CPB) to assess cerebral emboli and to estimate cerebral perfusion. We sought to compare TCD middle cerebral artery blood flow velocity (Vmca) to 133Xe clearance cerebral blood flo ... Full text Link to item Cite

Cost-benefit and efficacy of aprotinin compared with epsilon-aminocaproic acid in patients having repeated cardiac operations: a randomized, blinded clinical trial.

Journal Article Anesthesiology · December 1997 BACKGROUND: Aprotinin and epsilon-aminocaproic acid are routinely used to reduce bleeding during cardiac surgery. The marked difference in average wholesale cost between these two drug therapies (aprotinin, $1,080 vs. epsilon-aminocaproic acid, $11) has ge ... Full text Link to item Cite

Cognitive function 5 years after randomization to coronary angioplasty or coronary artery bypass graft surgery.

Journal Article Circulation · November 4, 1997 BACKGROUND: Coronary bypass surgery often leads to short-term cognitive dysfunction, whereas coronary angioplasty does not. Perioperative cognitive dysfunction usually resolves, although a subgroup of surgical patients may continue to exhibit long-term cog ... Link to item Cite

CACI in cardiac surgery.

Journal Article Anesthesiology · October 1997 Full text Link to item Cite

Feeling the heat.

Journal Article J Cardiothorac Vasc Anesth · October 1997 Full text Link to item Cite

The aging central nervous system

Journal Article Problems in Anesthesia · October 1, 1997 Cite

Preliminary report of a genetic basis for cognitive decline after cardiac operations. The Neurologic Outcome Research Group of the Duke Heart Center.

Other Ann Thorac Surg · September 1997 BACKGROUND: Changes in memory and cognition frequently follow cardiac operations. We hypothesized that patients with the apolipoprotein E-epsilon 4 allele are genetically predisposed to cognitive dysfunction after cardiac operations. METHODS: The apolipopr ... Full text Link to item Cite

epsilon-Aminocaproic acid plasma levels during cardiopulmonary bypass.

Journal Article Anesth Analg · August 1997 epsilon-Aminocaproic acid (EACA) concentrations achieved during cardiopulmonary bypass (CPB) have not been previously reported. It is unknown whether plasma concentrations reported to inhibit fibrinolysis in vitro (130 microg/mL) are achieved or whether di ... Full text Link to item Cite

Continuous jugular venous versus nasopharyngeal temperature monitoring during hypothermic cardiopulmonary bypass for cardiac surgery.

Journal Article J Clin Anesth · June 1997 STUDY OBJECTIVE: To compare jugular venous to nasopharyngeal temperature during hypothermic cardiopulmonary bypass (CPB). DESIGN: Prospective observational study. SETTING: Tertiary care teaching hospital. PATIENTS: 5 ASA physical status IV patients (40 to ... Full text Link to item Cite

Relationship of preoperative antiendotoxin core antibodies and adverse outcomes following cardiac surgery.

Journal Article JAMA · February 26, 1997 OBJECTIVE: To test the hypothesis that low serum antiendotoxin core antibody (EndoCAb) level is an independent predictor of adverse outcome following cardiac surgery. DESIGN: Prospective, blinded, cohort study. SETTING: Tertiary care medical center. SUBJEC ... Link to item Cite

Toward a new frontier in cardiac surgery.

Journal Article Ann Thorac Surg · February 1997 Full text Link to item Cite

Effect of temperature during cardiopulmonary bypass on gastric mucosal perfusion.

Journal Article Br J Anaesth · January 1997 The purpose of our study was to prospectively study the splanchnic response to hypothermic and tepid cardiopulmonary bypass (CPB) using alphastat management of arterial blood-gas tensions. Twenty-four patients for elective CABG surgery were allocated rando ... Full text Link to item Cite

CACl in cardiac surgery [8] (multiple letters)

Journal Article Anesthesiology · January 1, 1997 Cite

Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators.

Journal Article N Engl J Med · December 19, 1996 BACKGROUND: Acute changes in cerebral function after elective coronary bypass surgery is a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of -- and the use of resources associated with -- perioperat ... Full text Link to item Cite

Maintenance of therapeutic plasma aprotinin levels during prolonged cardiopulmonary bypass using a large-dose regimen.

Journal Article Anesth Analg · December 1996 Aprotinin concentrations in the range of 127-191 kallikrein inactivator units (KIU)/mL at the end of cardiopulmonary bypass (CPB) (< 2 h duration) reduce transfusion requirements. It has been suggested that prolonged CPB may require higher infusion rates w ... Full text Link to item Cite

Multicenter preoperative stroke risk index for patients undergoing coronary artery bypass graft surgery. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

Journal Article Circulation · November 1, 1996 BACKGROUND: The paradox of present cardiac surgery is that the more elderly and debilitated patients benefit most from cardiac surgery compared with medical therapy, yet they sustain greater overall risk for morbidity and mortality after cardiac surgery. T ... Link to item Cite

Effect of perfusion pressure on cerebral blood flow during normothermic cardiopulmonary bypass.

Journal Article Circulation · November 1, 1996 BACKGROUND: We have recently shown that during hypothermic cardiopulmonary bypass (CPB), cerebral autoregulation has a positive slope such that for every 10 mm Hg change in pressure, a 0.86 mL.100 g-1.min-1 change in cerebral blood flow (CBF) is predicted. ... Link to item Cite

Multicenter preoperative stroke risk index for patients undergoing coronary artery bypass graft surgery

Journal Article Circulation · November 1, 1996 Background: The paradox of present cardiac surgery is that the more elderly ad debilitated patients benefit most from cardiac surgery compared with medical therapy, yet they sustain greater overall risk for morbidity and mortality after cardiac surgery. Th ... Cite

Effect of perfusion pressure on cerebral blood flow during normothermic cardiopulmonary bypass

Journal Article Circulation · November 1, 1996 Background: We have recently shown that during hypothermic cardiopulmonary bypass (CPB), cerebral autoregulation has a positive slope such that for every 10 mm Hg change in pressure, a 0.86 mL · 100 g-1 · min-1 change in cerebral blood flow (CBF) is predic ... Cite

Defining neuropsychological dysfunction after coronary artery bypass grafting.

Journal Article Ann Thorac Surg · May 1996 BACKGROUND: Despite the large body of literature documenting the presence of cognitive decline after coronary artery bypass grafting, there is little consensus as to the frequency and extent of cognitive impairment. One potential reason for this lack of ag ... Full text Link to item Cite

Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease.

Journal Article J Thorac Cardiovasc Surg · May 1996 The purpose of this study was to evaluate long-term survival benefits of bypass surgery and angioplasty versus medical therapy in 9263 patients at Duke University Medical Center between 1984 and 1990 with coronary artery disease confirmed by cardiac cathet ... Full text Link to item Cite

Cardiac anesthetic: is it unique?

Journal Article Anesth Analg · November 1995 Full text Link to item Cite

Comparing two strategies of cardiopulmonary bypass cooling on jugular venous oxygen saturation in neonates and infants.

Journal Article Ann Thorac Surg · November 1995 BACKGROUND: Cerebral protection during deep hypothermic circulatory arrest is predicted on efficient and complete cerebral cooling. Institutions approach cooling quite differently. We compared two different cooling strategies in terms of measured jugular v ... Full text Link to item Cite

Cerebral physiologic effects of burst suppression doses of propofol during nonpulsatile cardiopulmonary bypass. CNS Subgroup of McSPI.

Journal Article Anesth Analg · September 1995 Central nervous system (CNS) complications are common after cardiac surgery. Death due to cardiac causes has decreased, but the number of deaths due to CNS injury has increased. As a first stage in the evaluation of its cerebral protection potential, we ev ... Full text Link to item Cite

Differential age effects of mean arterial pressure and rewarming on cognitive dysfunction after cardiac surgery.

Journal Article Anesth Analg · August 1995 Central nervous system dysfunction is a common consequence of otherwise uncomplicated cardiac surgery. Many mechanisms have been postulated for the cognitive dysfunction that is part of these neurologic sequelae. The purpose of our investigation was to eva ... Full text Link to item Cite

Jugular bulb saturation and mixed venous saturation during cardiopulmonary bypass.

Journal Article J Card Surg · July 1995 Systemic venous oxygen saturation is clinically used as an indicator of a satisfactory oxygen supply demand balance on cardiopulmonary bypass (CBP). Cerebral desaturation has been associated with postoperative cognitive dysfunction and has an incidence of ... Full text Link to item Cite

Predictors of cognitive decline after cardiac operation.

Journal Article Ann Thorac Surg · May 1995 Despite major advances in cardiopulmonary bypass technology, surgical techniques, and anesthesia management, central nervous system complications remain a common problem after cardiopulmonary bypass. The etiology of neuropsychologic dysfunction after cardi ... Full text Link to item Cite

Methodological issues in the assessment of neuropsychologic function after cardiac surgery.

Journal Article Ann Thorac Surg · May 1995 This report reviews critical issues facing investigators interested in neuropsychologic sequelae after cardiac operations: (1) experimental design; (2) selective attrition; (3) selection of instruments; (4) moderating factors; (5) definitions of cognitive ... Full text Link to item Cite

Depression in male and female patients undergoing cardiac surgery.

Journal Article Br J Clin Psychol · February 1995 The present longitudinal study was designed to determine the prevalence of depression in male and female patients undergoing cardiac surgery, and to examine what factors are associated with depression before and after surgery. One day prior to surgery (T1) ... Full text Link to item Cite

The Mini Mental State Exam as a predictor of neuropsychological functioning after cardiac surgery.

Journal Article Int J Psychiatry Med · 1995 OBJECTIVE: The present longitudinal study was designed to: 1) determine the ability of the Mini Mental State Exam (MMSE) to predict neuropsychologic impairment based on neuropsychologic testing five to seven days and six weeks after cardiac surgery; and 2) ... Full text Link to item Cite

Reply

Journal Article The Annals of Thoracic Surgery · January 1, 1995 Full text Cite

Jugular bulb saturation and cognitive dysfunction after cardiopulmonary bypass.

Journal Article Ann Thorac Surg · December 1994 Inadequate cerebral oxygenation during cardiopulmonary bypass may lead to postoperative cognitive dysfunction in patients undergoing cardiac operations. A psychological test battery was administered to 255 patients before cardiac operation and just before ... Full text Link to item Cite

Effect of aging on cerebral autoregulation during cardiopulmonary bypass. Association with postoperative cognitive dysfunction.

Journal Article Circulation · November 1994 BACKGROUND: Age is a predictor of cognitive dysfunction after cardiac surgery, but the mechanism is unknown. The purpose of our study was to determine whether age-related decrements in cognition are associated with cerebral blood flow (CBF) autoregulation ... Link to item Cite

Effect of aging on cerebral autoregulation during cardiopulmonary bypass: Association with postoperative cognitive dysfunction

Journal Article Circulation · November 1, 1994 Background: Age is a predictor of cognitive dysfunction after cardiac surgery, but the mechanism is unknown. The purpose of our study was to determine whether age-related decrements in cognition are associated with cerebral blood flow (CBF) autoregulation ... Cite

Pro: midazolam is the sedative of choice to supplement narcotic anesthesia.

Journal Article J Cardiothorac Vasc Anesth · October 1993 Having examined the options for adjuvant drug use during cardiac anesthesia, it becomes increasingly apparent that midazolam is "the drug" of choice and that supplementation with an opioid is an ideal adjuvant. In the hands of experienced cardiac anesthesi ... Full text Link to item Cite

Cerebral blood flow and metabolism during cardiopulmonary bypass.

Journal Article Anesth Analg · April 1993 Although much has been learned about cerebral physiology during CPB in the past decade, the role of alterations in CBF and CMRO2 during CPB and the unfortunately common occurrence of neuropsychologic injury still is understood incompletely. It is apparent ... Full text Link to item Cite

The effect of temperature on cerebral metabolism and blood flow in adults during cardiopulmonary bypass.

Journal Article J Thorac Cardiovasc Surg · March 1992 The effect of temperature on cerebral blood flow and metabolism was studied in 41 adult patients scheduled for operations requiring cardiopulmonary bypass. Plasma levels of midazolam and fentanyl were kept constant by a pharmacokinetic model-driven infusio ... Link to item Cite

Diabetic patients have abnormal cerebral autoregulation during cardiopulmonary bypass.

Journal Article Circulation · November 1990 We tested the hypothesis that insulin-dependent diabetic patients with coronary artery bypass graft surgery experience altered coupling of cerebral blood flow and oxygen consumption. In a study of 23 patients (11 diabetics and 12 age-matched controls), cer ... Link to item Cite