Document Detail


Choreoathetosis after deep hypothermia without circulatory arrest.
MedLine Citation:
PMID:  2241329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 8 of 758 patients undergoing an intracardiac operation under cardiopulmonary bypass and hypothermia, choreoathetosis developed 3 to 7 days postoperatively. Before the onset of choreoathetosis, varying degrees of neurological dysfunction were noted. Electroencephalography and neuroimaging failed to detect any responsible functional or structural changes. Six patients are alive 1 to 3 years postoperatively, and their condition is improving. Two patients died of aspiration or sepsis. All patients were grouped based on factors identified as being possibly causative: depth of hypothermia, cooling time, flow rate, and repeated hypothermia. The incidence of choreoathetosis was significantly different in group A (rectal temperature greater than 25 degrees C) compared with group B (rectal temperature less than or equal to 25 degrees C) (0/295 versus 8/463; p = 0.02). Based on cooling time, the incidence of choreoathetosis was significantly different in group B1 (cooling time less than 1 hour) compared with group B2 (cooling time greater than or equal to 1 hour) (1/220 versus 7/243; p = 0.05). Based on flow rate during cooling, group B2 was further divided into the low-flow group (less than 1,500 mL.min-1.m-2) and the high-flow group (greater than or equal to 1,500 mL.min-1.m-2). Although not significant, the incidence of choreoathetosis was higher in the high-flow group (6/153 versus 1/90; p = 0.22). In group B patients having reoperation, the incidence of choreoathetosis was higher than in patients operated on for the first time (5/54 versus 3/409; p less than or equal to 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S DeLeon; M Ilbawi; R Arcilla; A Cutilletta; R Egel; A Wong; J Quinones; T Husayni; M Obeid; R Sulayman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  50     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1990 Nov 
Date Detail:
Created Date:  1990-12-03     Completed Date:  1990-12-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  714-9     Citation Subset:  AIM; IM    
Affiliation:
Heart Institute for Children and Pediatric Neurology, Christ Hospital and Medical Center, Oak Lawn, IL 60453.
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MeSH Terms
Descriptor/Qualifier:
Athetosis / diagnosis,  epidemiology,  etiology*
Atrophy
Body Temperature
Brain / pathology,  physiology,  radiography
Cardiopulmonary Bypass / adverse effects*
Child, Preschool
Chorea / diagnosis,  epidemiology,  etiology*
Echoencephalography
Electroencephalography
Humans
Hypothermia, Induced / adverse effects*
Incidence
Infant
Magnetic Resonance Imaging
Reoperation
Retrospective Studies
Tomography, X-Ray Computed
Comments/Corrections
Comment In:
Ann Thorac Surg. 1990 Nov;50(5):693-4   [PMID:  2241325 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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