Copyright 2002 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2002
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
Yuh WTC, Knott-Craig CJ, Tilak MD. Cognitive Outcomes Following Cardiopulmonary Bypass. JAMA. 2002;287(23):3077–3079. doi:10.1001/jama.287.23.3077
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