{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T23:31:02Z","timestamp":1781220662891,"version":"3.54.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T00:00:00Z","timestamp":1734825600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,12,22]],"date-time":"2024-12-22T00:00:00Z","timestamp":1734825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The study objective was to determine the impact of cardiopulmonary bypass perfusion modalities on cerebral hemodynamics and clinical outcomes in congenital cardiac surgery patients stratified by acyanotic versus cyanotic heart disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 159 pediatric (age &lt;18 years) cardiac surgery patients were prospectively randomized to pulsatile or nonpulsatile cardiopulmonary bypass and stratified by type of congenital heart disease: acyanotic versus cyanotic. Intraoperative cerebral gaseous microemboli counts and middle cerebral artery pulsatility index were assessed. Organ injury was quantified by Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score at 24, 48, and 72\u2005h postoperatively. Additional outcomes included Pediatric Risk of Mortality-3 score, vasoactive\u2013inotropic score, duration of mechanical ventilation, intensive care and hospital length of stay, and 180-day mortality. Heterogenous variance linear models (ie, ANOVA and mixed models) and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests were used to compare groups for continuous and categorical variables, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Within congenital heart disease subgroups, patients randomized to nonpulsatile versus pulsatile bypass had similar preoperative and operative characteristics. While the intraoperative pulsatility index was higher in the pulsatile subset of both acyanotic and cyanotic groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05), regional cerebral oxygen saturation, mean arterial pressure, and gaseous microemboli counts were similar. Postoperative PELOD-2 scores decreased at similar rates in the acyanotic and cyanotic subgroups regardless of the perfusion modality utilized. There were also no significant between-group differences in the additional postoperative outcomes by perfusion modality in either acyanotic or cyanotic groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite patients undergoing pulsatile cardiopulmonary bypass experiencing a more physiologic pulsatility index in both acyanotic and cyanotic groups, no significant differences in cerebral hemodynamics or clinical outcomes were appreciated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351241288835","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T02:05:11Z","timestamp":1734919511000},"page":"329-337","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Randomized Trial of Pulsatile and Nonpulsatile Flow in Cyanotic and Acyanotic Congenital Heart Surgery"],"prefix":"10.1177","volume":"16","author":[{"given":"Krishna","family":"Patel","sequence":"first","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracie K.","family":"Lin","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Virginia Children's Hospital, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Clark","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary D.","family":"Ceneviva","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason R.","family":"Imundo","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Spear","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen R.","family":"Kunselman","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L.","family":"Myers","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3334-2886","authenticated-orcid":false,"given":"Akif","family":"\u00dcndar","sequence":"additional","affiliation":[{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"},{"name":"Penn State College of Medicine"},{"name":"Department of Biomedical Engineering, College of Engineering, The Pennsylvania State University, University Park, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046962"},{"key":"e_1_3_3_3_2","unstructured":"STS congenital heart surgery data summary\u2014all patients. 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