Centrifugal versus roller head pumps for cardiopulmonary bypass: effect on early neuropsychologic outcomes after coronary artery surgery.
OBJECTIVE
To test the hypothesis that routine use of a centrifugal pump in the cardiopulmonary bypass circuit would result in a lower incidence of early neuropsychologic deficit when compared with conventional roller pumps.


METHODS
Prospective, randomized, double-blind.


METHODS
University teaching hospital.


METHODS
Patients (n = 103) scheduled for elective coronary artery surgery.


METHODS
Patients were randomized into group C (centrifugal pump for cardiopulmonary bypass; n = 54) and group R (roller pump for cardiopulmonary bypass; n = 49).


RESULTS
A neuropsychologic test battery of 6 standard tests was administered before surgery and 5 days after surgery. An abnormal test result was defined as deterioration by >1 group SD from an individual's preoperative test performance. There were no significant differences between groups in preoperative or surgical parameters, intensive care unit stay, or hospital stay. There were no significant differences in the incidence of neuropsychologic deficit for patients with a deficit in at least 1 test (group C, 33%; group R, 51%; odds ratio, 0.48; 95% confidence interval, 0.22 to 1.06) or patients with a deficit in >/=2 tests (group C, 6%; group R, 18%; odds ratio, 0.26; 95% confidence interval, 0.07 to 1.03). In group R, there were more individual test deficits per patient than in group C (p = 0.04).


CONCLUSIONS
There was no significant difference in the incidence of neuropsychologic deficit postoperatively with routine use of centrifugal pumps. The larger number of individual test deficits in the roller pump group suggest that further studies to assess the potential neuropsychologic benefits of the use of centrifugal pumps are warranted.
Scott
David A
DA
Center for Anaesthesia and Cognitive Function, Department of Anaesthesia and Intensive Care, St. Vincent's Hospital, Melbourne, Australia. scottda@svhm.org.au
Silbert
Brendan S
BS
Doyle
Timothy J
TJ
Blyth
Carolyn
C
Borton
Mary C
MC
O'brien
Jennifer L
JL
de L  Horne
David J
DJ
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications; D011446:Prospective Studies