Same Cognition With Cerebral Perfusion, Hypothermic Arrest

Similar cognitive benefit for antegrade cerebral perfusion, deep hypothermic circulatory arrest

FRIDAY, Oct. 14 (HealthDay News) -- For patients undergoing pulmonary endarterectomy (PEA), antegrade cerebral perfusion (ACP) confers no additional benefits over deep hypothermic circulatory arrest (DHCA) for improving cognitive function, according to a study published in the Oct. 15 issue of The Lancet.

Alain Vuylsteke, M.D., from the Papworth Hospital National Health Service Foundation Trust in Cambridge, U.K., and colleagues compared the benefits of maintaining ACP versus DHCA in 74 patients (aged 18 to 80 years) who underwent PEA. A total of 35 and 39 patients randomly received DHCA for up to 20 min at 20 degrees Celsius or ACP (1:1 ratio), respectively. The change in cognitive function at 12 weeks after surgery was assessed by the trail-making A and B tests, the Rey auditory verbal learning test, and the grooved pegboard test.

The investigators found that nine patients changed from ACP to DHCA to facilitate complete endarterectomy. The mean differences in Z scores between the two groups at 12 weeks were not significant for any of the tests. Cognitive function improved at 12 weeks in all the patients. The two groups showed no significant difference in terms of adverse events. Two patients from the DHCA group and one from the ACP group died.

"In the setting of PEA, maintenance of cerebral perfusion throughout the procedure adds to the complexity of an operation and confers no additional benefits," the authors write.

One of the study authors disclosed a financial relationship with Covidien, owner of Somanetics, for lectures on the use of near-infrared spectroscopy.

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