Pediatric Cardiology

, Volume 26, Issue 1, pp 34–38

Profound Hypothermia with Alpha-Stat pH Management During Open-Heart Surgery Is Associated with Choreoathetosis

Authors

  • D.A. Levin
    • Division of Pediatric CardiologyThe Children’s Hospital, University of Colorado Health Sciences Center
  • A.R. Seay
    • Division of Child NeurologyThe Children’s Hospital, University of Colorado Health Sciences Center
  • D.A. Fullerton
    • Department of Cardiothoracic SurgeryUniversity of Colorado Health Sciences Center
  • E.A.F. Simoes
    • Department of Pediatric Infectious DiseasesThe Children’s Hospital, University of Colorado Health Sciences Center
    • Department of Paediatrics, Obstetrics and GynaecologySt. Mary’s Hospital, The Imperial College
    • Division of Pediatric CardiologyThe Children’s Hospital, University of Colorado Health Sciences Center
Article

DOI: 10.1007/s00246-004-0669-6

Cite this article as:
Levin, D., Seay, A., Fullerton, D. et al. Pediatr Cardiol (2005) 26: 34. doi:10.1007/s00246-004-0669-6

Abstract

A retrospective chart review was conducted to examine risk factors associated with the occurrence of choreoathetosis, a rare but significant complication of open-heart surgery in children. Ten children were identified as having developed choreoathetosis after cardiac surgery. Their charts were reviewed and compared with 33 age- and diagnosis-matched controls who underwent open-heart surgery during the same time period. Children with choreoathetosis reached lower rectal and esophageal temperatures (p = 0.0018 for both) and spent a greater portion of total bypass time at lower rectal and esophageal temperatures (p < 0.001 for both). Duration of cooling below 20°C esophageal temperature and PaCO2 at the end of the cooling period were significant predictors of choreoathetosis (p = 0.023 and p = 0.0497, respectively) in a logistic regression model, and a greater fraction of choreoathetosis patients had prior developmental delays (p = 0.017). No difference was found in the age at surgery, duration of bypass, aortic cross-clamp time, arterial pH, PaCO2 or mean arterial pressure. The combination of extended exposure to profound hypothermia and alpha-stat pH management strategy and preexisting developmental delay are associated with the development of choreoathetosis following open-heart surgery 61 in children.

Keywords

ChoreoathetosisHypothermiaCardiopuhnonary bypass

Copyright information

© Springer-Verlag 2004