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June 19, 2002

Cognitive Outcomes Following Cardiopulmonary Bypass

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(23):3077-3079. doi:10.1001/jama.287.23.3077

To the Editor: The results of Dr Van Dijk and colleagues1 do not appear to have resolved the conflicting conclusions drawn from the 2 prior randomized trials that have found that off-pump CABG reduced the postoperative cognitive dysfunction.2,3 One potential limitation of all these studies is the adequacy of management of the patient during CPB. Relevant variables would include maintaining an appropriate hematocrit, high flow rate, and mean perfusion pressure while on bypass, and having a blood filter on the arterial limb of the bypass circuit. These differences could greatly influence cerebral morbidity.