A randomized clinical trial of regional cerebral perfusion versus deep hypothermic circulatory arrest: Outcomes for infants with functional single ventricle
A randomized clinical trial of regional cerebral perfusion versus deep hypothermic circulatory arrest: Outcomes for infants with functional single ventricle
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DOI：
10.1016/j.jtcvs.2006.11.029
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发表时间：
2007-04-01
影响因子：
6
通讯作者：
Ohye, Richard G.
中科院分区：
文献类型：
--
作者：
Goldberg, Caren S.;Bove, Edward L.;Ohye, Richard G.
目的：在主动脉弓重建中，局部脑灌注已被用作改善神经保护的一种手段。这项研究的目的是确定在主动脉弓重建期间采用局部脑灌注策略而不是深低温停循环策略是否可以在不增加诺伍德手术患者并发症和死亡率的情况下改善神经发育。方法：对接受诺伍德手术的单脑室解剖的婴儿进行随机试验。参与者被随机分为深低温停循环组或局部脑灌注组。在二期手术前和术后1年分别采用贝利婴儿发育量表II、精神运动发育指数和智力发育指数测量神经发育。进行意向处理分析。结果：共纳入77例患者。出院前存活率为88%，1年随访存活率为75%，两组间无显著差异。在整个队列中，二期手术前精神运动发育指数(SD)平均为77分(20分)，智力发展指数平均为92分(21分)，心理运动发育指数均低于智力发育指数(P
Objective: Regional cerebral perfusion has been adopted as a means to improve neuroprotection during aortic arch reconstruction. The purpose of this study was to determine whether a strategy of regional cerebral perfusion rather than one of deep hypothermic circulatory arrest during aortic arch reconstruction would improve neurodevelopment without increasing morbidity or mortality for patients undergoing the Norwood operation.Methods: A randomized trial was performed in infants with single ventricle anatomy undergoing the Norwood operation. Participants were randomized to deep hypothermic circulatory arrest or regional cerebral perfusion. Neurodevelopment was measured before second-stage surgery and at 1 year by the Bayley Scales of Infant Development-II, Psychomotor Development Index and Mental Development Index. Intent-to-treat analysis was performed.Results: Seventy-seven patients were enrolled. Survival to hospital discharge was 88% and to 1-year follow-up, 75%, without a significant difference between groups. For the entire cohort, the mean (SD) psychomotor development index score was 77 ( 20) and the mean mental development index score was 92 ( 21), with psychomotor development index lower than mental development index both before second-stage surgery (P