Carbon dioxide insufflation in open-chamber cardiac surgery: a double-blind, randomized clinical trial of neurocognitive effects

The Journal of Thoracic and Cardiovascular Surgery
Krish ChaudhuriSilvana Marasco

Abstract

The aims of this study were first to analyze neurocognitive outcomes of patients after open-chamber cardiac surgery to determine whether carbon dioxide pericardial insufflation reduces incidence of neurocognitive decline (primary end point) as measured 6 weeks postoperatively and second to assess the utility of carbon dioxide insufflation in cardiac chamber deairing as assessed by transesophageal echocardiography. A multicenter, prospective, double-blind, randomized, controlled trial compared neurocognitive outcomes in patients undergoing open-chamber (left-sided) cardiac surgery who were assigned carbon dioxide insufflation or placebo (control group) in addition to standardized mechanical deairing maneuvers. One hundred twenty-five patients underwent surgery and were randomly allocated. Neurocognitive testing showed no clinically significant differences in z scores between preoperative and postoperative testing. Linear regression was used to identify factors associated with neurocognitive decline. Factors most strongly associated with neurocognitive decline were hypercholesterolemia, aortic atheroma grade, and coronary artery disease. There was significantly more intracardiac gas noted on intraoperative transesophageal echocar...Continue Reading

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Citations

Jan 17, 2013·The Journal of Thoracic and Cardiovascular Surgery·Marko BorojevicBojan Biocina
Apr 4, 2015·PloS One·Emma M L ChungJames P Hague
Dec 13, 2017·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Quang-Huy DangThi-Hai-Linh Ngo
Apr 6, 2018·Anesthesiology·Miles BergerJoseph P Mathew
Oct 12, 2018·Journal of the American Geriatrics Society·Mark A OldhamHochang B Lee
Oct 3, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alexander WahbaUNKNOWN EACTS/EACTA/EBCP Committee Reviewers
Jul 6, 2019·JRSM Cardiovascular Disease·Ethan D HindsReynolds Delgado
Oct 29, 2020·Perfusion·Ignazio CondelloGiuseppe Speziale

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