ArticleThe Journal of thoracic and cardiovascular surgery2014
Predictors of electrocerebral inactivity with deep hypothermia.
Article in The Journal of thoracic and cardiovascular surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Guidelines for the use of cerebral oximetry by near-infrared spectroscopy in cardiovascular anesthesia: a report by the cerebrospinal Division of the Academic Committee of the Japanese Society of Cardiovascular Anesthesiologists (JSCVA).Journal of anesthesia · 2019Guideline
- Trial
- Cerebral protection: Antegrade cerebral perfusion in the modern era. Does temperature matter?JTCVS techniques · 2024Article
- Perioperative electroencephalography in cardiac surgery with hypothermic circulatory arrest: a narrative review.Interactive cardiovascular and thoracic surgery · 2022Review
- Post-Operative Kidney Function Using Deep Hypothermic Circulatory Arrest (DHCA) in Aortic Arch Operation.International journal of nephrology and renovascular disease · 2022Article
- Does deeper hypothermia reduce the risk of acute kidney injury after circulatory arrest for aortic arch surgery?European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2021Article
- Hypothermia during Surgical Treatment of Type A Aortic Dissection: A 16 Years' Experience.International journal of vascular medicine · 2020Article
- Aortic arch aneurysm surgery: what is the gold standard temperature in the absence of randomized data?General thoracic and cardiovascular surgery · 2019Review
- Electroencephalographic Response to Deep Hypothermic Circulatory Arrest in Neonatal Swine and Humans.The Annals of thoracic surgery · 2018Article
- Neuroprotective Strategies in Repair and Replacement of the Aortic Arch.The International journal of angiology : official publication of the International College of Angiology, Inc · 2018Review
- Intraoperative care for aortic surgery using circulatory arrest.Journal of thoracic disease · 2017Review
- Does moderate hypothermia really carry less bleeding risk than deep hypothermia for circulatory arrest? A propensity-matched comparison in hemiarch replacement.The Journal of thoracic and cardiovascular surgery · 2016Article
- The utility of the aortic dissection team: outcomes and insights after a decade of experience.Annals of cardiothoracic surgery · 2016Article
- Prolonged postoperative respiratory support after proximal thoracic aortic surgery: Is deep hypothermic circulatory arrest a risk factor?Journal of critical care · 2016Article
- Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest.The Annals of thoracic surgery · 2016Article
- Use of human fibrinogen concentrate during proximal aortic reconstruction with deep hypothermic circulatory arrest.The Journal of thoracic and cardiovascular surgery · 2016Article
- The human burst suppression electroencephalogram of deep hypothermia.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2015Article
- Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.The Journal of thoracic and cardiovascular surgery · 2014Article
- "Open" approach to aortic arch aneurysm repair.Journal of the Saudi Heart Association · 2014Review
- Outcomes of acute type a dissection repair before and after implementation of a multidisciplinary thoracic aortic surgery program.Journal of the American College of Cardiology · 2014Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveCooling to electrocerebral inactivity (ECI) by electroencephalography (EEG) remains the gold standard to maximize cerebral and systemic organ protection during deep hypothermic circulatory arrest (DHCA). We sought to determine predictors of ECI to help guide cooling protocols when EEG monitoring is unavailable.
methodsBetween July 2005 and July 2011, 396 patients underwent thoracic aortic operation with DHCA; EEG monitoring was used in 325 (82%) of these patients to guide the cooling strategy, and constituted the study cohort. Electroencephalographic monitoring was used for all elective cases and, when available, for nonelective cases. Multivariable linear regression was used to assess predictors of the nasopharyngeal temperature and cooling time required to achieve ECI.
resultsCooling to a nasopharyngeal temperature of 12.7°C or for a duration of 97 minutes was required to achieve ECI in >95% of patients. Only 7% and 11% of patients achieved ECI by 18°C or 50 minutes of cooling, respectively. No independent predictors of nasopharyngeal temperature at ECI were identified. Independent predictors of cooling time included body surface area (18 minutes/m(2)), white race (7 minutes), and starting nasopharyngeal temperature (3 minutes/°C). Low complication rates were observed (ischemic stroke, 1.5%; permanent paraparesis/paraplegia, 1.5%; new-onset dialysis, 2.2%; and 30-day/in-hospital mortality, 4.3%).
conclusionsCooling to a nasopharyngeal temperature of 12.7°C or for a duration of 97 minutes achieved ECI in >95% of patients in our study population. However, patient-specific factors were poorly predictive of the temperature or cooling time required to achieve ECI, necessitating EEG monitoring for precise ECI detection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.