Pediatric Cardiology

, Volume 26, Issue 1, pp 34–38

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

  • D.A. Levin
  • A.R. Seay
  • D.A. Fullerton
  • E.A.F. Simoes
  • H.M. Sondheimer
Article

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

Choreoathetosis Hypothermia Cardiopuhnonary bypass 

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • D.A. Levin
    • 1
  • A.R. Seay
    • 2
  • D.A. Fullerton
    • 3
  • E.A.F. Simoes
    • 4
    • 5
  • H.M. Sondheimer
    • 1
  1. 1.Division of Pediatric CardiologyThe Children’s Hospital, University of Colorado Health Sciences CenterDenverUSA
  2. 2.Division of Child NeurologyThe Children’s Hospital, University of Colorado Health Sciences CenterDenverUSA
  3. 3.Department of Cardiothoracic SurgeryUniversity of Colorado Health Sciences CenterUSA
  4. 4.Department of Pediatric Infectious DiseasesThe Children’s Hospital, University of Colorado Health Sciences CenterDenverUSA
  5. 5. Department of Paediatrics, Obstetrics and GynaecologySt. Mary’s Hospital, The Imperial CollegeLondonUnited Kingdom

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