(From the March 2014 issue of Research Now)
The cardiac anesthesia team recently completed the second arm of a prospective randomized study evaluating the impact of anesthetic management on the stress response for children undergoing cardiac surgery requiring cardiopulmonary bypass (CPB). In the original study, which was recently published in the Journal of Pediatric Critical Care Medicine, the team established the benefits of using a high dose of fentanyl either alone or in combination with dexmedetomidine in blunting or decreasing the stress response during cardiac surgery requiring CPB. This improved stress response was associated with improved clinical outcomes such as decreased postoperative bleeding and decreased need for blood transfusion.
In a follow-up study in collaboration with Dr. Keith Yeates from the Center for Biobehavioral Health, the cardiac anesthesia team conducted neurodevelopmental testing on the children who were previously enrolled in the original study. The goal was to evaluate the correlation, if any, between blunting the stress response and improved neurodevelopmental outcomes. In addition, the team did a multiple regression analysis to determine the possible impact of the prenatal/parental and perioperative factors on the neurodevelopmental scores. Recruitment and testing of patients is now finished and the team is currently preparing to submit results for publication.
Aymen N. Naguib, MD, is a clinical researcher and director of Anesthesiology at The Heart Center at Nationwide Children's Hospital.
Naguib AN, Tobias JD, Hall MW, Cismowski MJ, Miao Y, Barry N, Preston T, Galantowicz M, Hoffman TM. The role of different anesthetic techniques in altering the stress response during cardiac surgery in children: a prospective, double-blinded, and randomized study. Journal of Pediatric Critical Care Medicine. 2013 Jun, 14(5):481-90.