Developmental and neurologic status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass

Article Abstract:

Infants who undergo heart surgery performed with deep hypothermia and circulatory arrest to support vital organs during surgery may experience delayed motor development and neurologic abnormalities at one year of age. A study of 155 infants who underwent heart surgery found that infants whose heart surgery included total circulatory arrest were more likely to have lower scores on psychomotor development and neurologic tests than were infants whose heart surgery included low-flow cardiopulmonary bypass to support vital organs during surgery. Use of circulatory arrest for longer than 35 minutes may adversely affect scores on psychomotor development tests at one year of age. Children with circulatory arrest periods longer than 45 minutes experienced substantial deficits. Many of the children in the study showed evidence of seizures in the 48 hours after surgery. Infants with seizures had worse outcomes at one year of age than did infants without seizures. Future assessments as the children approach school age may clarify whether the deficits experienced at one year will influence academic ability.

Complications and side effects, Physiological aspects, Infants, Motor ability, Motor skills, Infant development, Coronary artery bypass, Hypothermia, Induced, Induced hypothermia

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Equivalence trials

Article Abstract:

Conclusions drawn from studies comparing the effectiveness of two therapies may depend on how the investigators designed the study and statistically analyzed the data. Researchers who designed two recent studies on therapies used soon after heart attacks found similar death rates with their compared therapies but arrived at different conclusions. However, each investigator used different criteria for defining equivalent effectiveness. The statistical number of treated patients needed to arrive at a proposed conclusion can also influence study design.

Methods, Evaluation, Drugs, Clinical trials, Drug evaluation

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Particulate air pollution and mortality -- clearing the air

Article Abstract:

Researchers should attempt to identify the most harmful components of particulate air pollution. Particulate air pollution has been linked to excess deaths from cardiovascular and respiratory diseases. However, it would be very costly to reduce the amount of particulate matter in the atmosphere to the extent that the EPA has proposed.

Health aspects, Mortality, Environmental aspects, Air pollution

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