{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:47:03Z","timestamp":1790275623978,"version":"4.1.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"S 03","license":[{"start":{"date-parts":[[2024,6,23]],"date-time":"2024-06-23T00:00:00Z","timestamp":1719100800000},"content-version":"vor","delay-in-days":174,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Hypothermia is a neuroprotective strategy during cardiopulmonary bypass. Rewarming entailing a rapid rise in cerebral metabolism might lead to secondary neurological sequelae. In this pilot study, we aimed to validate the hypothesis that a slower rewarming rate would lower the risk of cerebral hypoxia and seizures in infants.<\/jats:p><jats:p>\n          Methods\u2003This is a prospective, clinical, single-center study. Infants undergoing cardiac surgery in hypothermia were rewarmed either according to the standard (+1\u00b0C in\u2009&lt;\u20095\u2009minutes) or a slow (+1\u00b0C in\u2009&gt;\u20095\u20138\u2009minutes) rewarming strategy. We monitored electrocortical activity via amplitude-integrated electroencephalography (aEEG) and cerebral oxygenation by near-infrared spectroscopy during and after surgery.<\/jats:p><jats:p>\n          Results\u2003Fifteen children in the standard rewarming group (age: 13 days [5\u2013251]) were cooled down to 26.6\u00b0C (17.2\u201329.8) and compared with 17 children in the slow-rewarming group (age: 9 days [4\u2013365]) with a minimal temperature of 25.7\u00b0C (20.1\u201331.4). All neonates in both groups (n\u2009=\u200919) exhibited suppressed patterns compared with 28% of the infants\u2009&gt;\u200928 days (p\u2009&lt;\u20090.05). During rewarming, only 26% of the children in the slow-rewarming group revealed suppressed aEEG traces (vs. 41%; p\u2009=\u20090.28). Cerebral oxygenation increased by a median of 3.5% in the slow-rewarming group versus 1.5% in the standard group (p\u2009=\u20090.9). Our slow-rewarming group revealed no aEEG evidence of any postoperative seizures (0 vs. 20%).<\/jats:p><jats:p>\n          Conclusion\u2003These results might indicate that a slower rewarming rate after hypothermia causes less suppression of electrocortical activity and higher cerebral oxygenation during rewarming, which may imply a reduced risk of postoperative seizures.<\/jats:p>","DOI":"10.1055\/s-0044-1787650","type":"journal-article","created":{"date-parts":[[2024,6,23]],"date-time":"2024-06-23T22:32:17Z","timestamp":1719181937000},"page":"e7-e15","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Neurological Impact of Slower Rewarming during Bypass Surgery in Infants"],"prefix":"10.1055","volume":"72","author":[{"given":"Geeske","family":"Muehlschlegel","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9125-8626","authenticated-orcid":false,"given":"Rouven","family":"Kubicki","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg Bad Krozingen Freiburg Branch, Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Jacobs-LeVan","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Clinical Neurosciences, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kroll","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen Freiburg Branch, Freiburg, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Klemm","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University Heart Center Freiburg Bad Krozingen, Freiburg, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Humburger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Freiburg Medical Center Freiburg, Freiburg, Baden-W\u00fcrttemberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Stiller","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg Bad Krozingen Freiburg Branch, Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilo","family":"Fleck","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Center Freiburg Bad Krozingen Freiburg Branch, Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,6,23]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1203\/00006450-199512000-00015","article-title":"Quantitative relationship between brain temperature and energy utilization rate measured in vivo using 31P and 1H magnetic resonance spectroscopy","volume":"38","author":"A R Laptook","year":"1995","journal-title":"Pediatr Res"},{"issue":"13","key":"ref2","doi-asserted-by":"crossref","first-page":"7061","DOI":"10.3390\/ijerph18137061","article-title":"The role of deep hypothermia in cardiac surgery","volume":"18","author":"R Goco\u0142","year":"2021","journal-title":"Int J Environ Res Public Health"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.athoracsur.2010.03.047","article-title":"Early and long-term outcome of total arch replacement using selective cerebral perfusion","volume":"90","author":"M Minakawa","year":"2010","journal-title":"Ann Thorac Surg"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/S0022-5223(03)00940-1","article-title":"The effect of duration of deep hypothermic circulatory arrest in infant heart surgery on late neurodevelopment: the Boston Circulatory Arrest Trial","volume":"126","author":"D Wypij","year":"2003","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1038\/jp.2010.146","article-title":"Physiologic and pharmacologic considerations for hypothermia therapy in neonates","volume":"31","author":"S Zanelli","year":"2011","journal-title":"J Perinatol"},{"issue":"02","key":"ref6","first-page":"133","article-title":"Therapeutic hypothermia in neonatal asphyxia","volume":"4","author":"L Cornette","year":"2012","journal-title":"Facts Views Vis ObGyn"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1017\/S0265021505000499","article-title":"Monitoring of selective antegrade cerebral perfusion using near infrared spectroscopy in neonatal aortic arch surgery","volume":"22","author":"A Hofer","year":"2005","journal-title":"Eur J Anaesthesiol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.athoracsur.2011.08.014","article-title":"Amplitude-integrated electroencephalography and brain injury in infants undergoing Norwood-type operations","volume":"93","author":"J K Gunn","year":"2012","journal-title":"Ann Thorac Surg"},{"issue":"08","key":"ref9","doi-asserted-by":"crossref","first-page":"e0183581","DOI":"10.1371\/journal.pone.0183581","article-title":"Effect of general anesthesia on neonatal aEEG-A cohort study of patients with non-cardiac congenital anomalies","volume":"12","author":"L J Stolwijk","year":"2017","journal-title":"PLoS One"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"e76","DOI":"10.1542\/neo.7-2-e76","article-title":"Amplitude-integrated EEG classification and interpretation in preterm and term infants","volume":"7","author":"L Hellstrom-Westas","year":"2006","journal-title":"Neoreviews"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1007\/s00134-012-2608-y","article-title":"Perioperative amplitude-integrated EEG and neurodevelopment in infants with congenital heart disease","volume":"38","author":"J K Gunn","year":"2012","journal-title":"Intensive Care Med"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00221-005-2300-3","article-title":"Cerebral oxygen saturation and electrical brain activity before, during, and up to 36\u2009hours after arterial switch procedure in neonates without pre-existing brain damage: its relationship to neurodevelopmental outcome","volume":"165","author":"M C Toet","year":"2005","journal-title":"Exp Brain Res"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.jtcvs.2009.03.071","article-title":"An empirically based tool for analyzing mortality associated with congenital heart surgery","volume":"138","author":"S M O'Brien","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1203\/PDR.0b013e3181da44ba","article-title":"Effect of sedation and analgesia on postoperative amplitude-integrated EEG in newborn cardiac patients","volume":"67","author":"V Bernet","year":"2010","journal-title":"Pediatr Res"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1016\/j.jtcvs.2013.03.022","article-title":"Predictors of electrocerebral inactivity with deep hypothermia","volume":"147","author":"M L James","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.neuroimage.2018.06.043","article-title":"Suppression of underlying neuronal fluctuations mediates EEG slowing during general anaesthesia","volume":"179","author":"A Hutt","year":"2018","journal-title":"Neuroimage"},{"issue":"12","key":"ref17","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.1177\/0271678X18789273","article-title":"Effects of anesthesia on cerebral blood flow, metabolism, and neuroprotection","volume":"38","author":"A M Slupe","year":"2018","journal-title":"J Cereb Blood Flow Metab"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.siny.2010.05.005","article-title":"Mechanisms of hypothermic neuroprotection","volume":"15","author":"P P Drury","year":"2010","journal-title":"Semin Fetal Neonatal Med"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.jtcvs.2009.08.022","article-title":"Brain immaturity is associated with brain injury before and after neonatal cardiac surgery with high-flow bypass and cerebral oxygenation monitoring","volume":"139","author":"D B Andropoulos","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/j.1525-1594.2012.01554.x","article-title":"Cerebral perfusion during cardiopulmonary bypass in children: correlations between near-infrared spectroscopy, temperature, lactate, pump flow, and blood pressure","volume":"37","author":"S Haydin","year":"2013","journal-title":"Artif Organs"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"II231","DOI":"10.1161\/01.CIR.0000138945.78346.9c","article-title":"Selective antegrade cerebral perfusion attenuates brain metabolic deficit in aortic arch surgery: a prospective randomized trial","volume":"110","author":"D K Harrington","year":"2004","journal-title":"Circulation"},{"issue":"12","key":"ref22","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.earlhumdev.2010.08.028","article-title":"Amplitude integrated electroencephalographic activity in infants with congenital heart disease before surgery","volume":"86","author":"H J ter Horst","year":"2010","journal-title":"Early Hum Dev"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1038\/s41390-020-1085-1","article-title":"Determinants of neurological outcome in neonates with congenital heart disease following heart surgery","volume":"89","author":"V A Kuhn","year":"2021","journal-title":"Pediatr Res"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jpeds.2016.06.050","article-title":"Postoperative amplitude-integrated electroencephalography predicts four-year neurodevelopmental outcome in children with complex congenital heart disease","volume":"178","author":"B Latal","year":"2016","journal-title":"J Pediatr"},{"issue":"04","key":"ref25","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1007\/s00134-017-4709-0","article-title":"Targeted temperature management after intraoperative cardiac arrest: a multicenter retrospective study","volume":"43","author":"A-L Constant","year":"2017","journal-title":"Intensive Care Med"},{"issue":"11","key":"ref26","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1161\/CIRCULATIONAHA.108.791384","article-title":"Hypothermia therapy after pediatric cardiac arrest","volume":"119","author":"D R Doherty","year":"2009","journal-title":"Circulation"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.xjon.2021.05.020","article-title":"Mild hypothermia versus normothermia in patients undergoing cardiac surgery","volume":"7","author":"V Bianco","year":"2021","journal-title":"JTCVS Open"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4103\/aer.AER_123_19","article-title":"Normothermia versus hypothermia during cardiopulmonary bypass in cases of repair of atrioventricular septal defect","volume":"14","author":"G F Amer","year":"2020","journal-title":"Anesth Essays Res"},{"issue":"04","key":"ref29","doi-asserted-by":"crossref","first-page":"e2021050875","DOI":"10.1542\/peds.2021-050875","article-title":"Cognitive and executive function in congenital heart disease: a meta-analysis","volume":"148","author":"M Feldmann","year":"2021","journal-title":"Pediatrics"},{"issue":"03","key":"ref30","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1097\/00004647-200203000-00011","article-title":"Near-infrared spectroscopy cerebral oxygen saturation thresholds for hypoxia-ischemia in piglets","volume":"22","author":"C D Kurth","year":"2002","journal-title":"J Cereb Blood Flow Metab"}],"container-title":["The Thoracic and Cardiovascular Surgeon"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0044-1787650.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T11:34:26Z","timestamp":1730806466000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0044-1787650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":30,"journal-issue":{"issue":"S 03","published-online":{"date-parts":[[2024,6,4]]},"published-print":{"date-parts":[[2024,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0044-1787650","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0171-6425","1439-1902"],"issn-type":[{"value":"0171-6425","type":"print"},{"value":"1439-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}