title: Effects of propofol on cerebral oxygenation during cardiopulmonary bypass in children.
abstract: OBJECTIVE
  Neurologic complications occur following cardiopulmonary bypass surgery. We conducted a randomized, controlled, single-blind study to determine the effect of propofol on the redox status of cytaa3, and to evaluate its potential for decreasing neurologic complications.
  
  
  METHODS
  Twenty-four children (median age: 3.3 yr; median weight: 14.4 kg) scheduled for elective cardiopulmonary bypass surgery were assigned to either the experimental group (Group P, given sufficient propofol to eliminate brain electrical activity as measured on EEG (i.e. burst suppression)) or the control group (Group C, no propofol). Near infrared spectroscopy data were collected at one-second intervals throughout the surgical procedures. Pre- and postoperative neurologic examinations were completed by a physician blinded to the group to which the patient was assigned. Change in cytochrome aa3 data at 10-min intervals (10, 20, 30, 40 min) following start of bypass were compared between groups by repeated measures analysis of variance.
  
  
  RESULTS
  The patterns of change in redox state of cytochrome were different between the two groups (P < 0.002). The pattern of change within Group P was similar to that in hypothermic patients in Group C. There were correlations between change in cytaa3 redox status and temperature in the control subjects. There were no gross neurologic complications in either group.
  
  
  CONCLUSIONS
  Propofol appears to stabilize the energy supply/demand equilibrium of the brain during cardiopulmonary bypass surgery and thus theoretically could reduce the incidence or severity of neurologic complications.
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Children's and Women's Hospital of British Columbia, University of British Columbia, Vancouver, Canada. jleblanc@dowco.com
authors.forename: J G
authors.initials: JG
authors.lastname: LeBlanc
authors.forename: D
authors.initials: D
authors.lastname: Blackstock
authors.forename: A J
authors.initials: AJ
authors.lastname: Macnab
authors.forename: F
authors.initials: F
authors.lastname: Gagnon
authors.forename: R
authors.initials: R
authors.lastname: Gagnon
authors.forename: J
authors.initials: J
authors.lastname: Russell
authors.forename: T
authors.initials: T
authors.lastname: Ring
mesh_terms: D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001921:Brain / Q000187:drug effects* / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D003576:Electron Transport Complex IV / Q000378:metabolism; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D015742:Propofol / Q000494:pharmacology*; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D018686:Anesthetics, Intravenous; D006454:Hemoglobins; D003576:Electron Transport Complex IV; D010100:Oxygen; D015742:Propofol