Two teams of investigators from Duke Anesthesiology won a “Best of Abstracts: Clinical Science” award for their clinical circulation studies at the American Society of Anesthesiologists 2016 Annual Meeting in Chicago. Only ten of the top clinical abstracts were selected (out of about 1,100) to be featured in this special session.
One clinical science award went to the project titled, “Interrelationship of Preoperative Anemia, Postoperative Anemia, Acute Kidney Injury And Mortality After Coronary Artery Bypass Grafting Surgery.” Authors of this project include: Patrick Nailer, MD, Manuel Fontes, MD, Ishwori Dhakal, MSc, Jorn Karhausen, MD, Mihai Podgoreanu, MD, Mark Stafford-Smith, MD, and Miklos Kertai, MD, PhD.
Preoperative and postoperative anemia have individually been identified as potential risk factors for postoperative complications after coronary artery bypass grafting (CABG) surgery, but their interrelationship with acute kidney injury (AKI) has not been clearly defined. The authors’ findings reveal that anemia prior to and/or after surgery, are associated with an incremental risk of postoperative AKI. Further, only preoperative anemia and the combination of pre- and postoperative anemia have a significant relation with long-term mortality after CABG surgery.
Another clinical science award went to the project titled, “Impact of Temperature on Cognition and Brain Connectivity Following Hypothermic Surgical Circulatory Arrest.” Authors of this project include: Rebecca Klinger, MD, MS, Jeffrey Browndyke, PhD, Tiffany Bisanar, BSN, Mary Cooter, MS, Miles Berger, MD, PhD, Mihai Podgoreanu, MD, Jorn Karhausen, MD, Mark Newman, MD, G. Chad Hughes, MD, and Joseph Mathew, MD, MBA.
The use of deep hypothermia (<20°C) for cerebral protection ushered in the modern era of safe and effective operation on the aorta during circulatory arrest. In light of concerns over the longer cardiopulmonary bypass (CPB) duration needed for deep hypothermia, many centers now routinely employ moderate hypothermia (low-moderate: 20.1-24.0°C; high-moderate: 24.1-28.0°C) coupled with selective antegrade cerebral perfusion. However, the optimal temperature for hypothermic circulatory arrest (HCA) remains unclear. The authors hypothesized that deep hypothermia would reduce postoperative cognitive decline and preserve functional brain network connectivity when compared with high-moderate hypothermia. Their findings reveal that deep hypothermia may be superior to high-moderate hypothermia in mitigating against postoperative cognitive decline and in preserving functional brain connectivity after circulatory arrest for arch surgery.