NB: Submission of an abstract and presentation at the Update on Cardiopulmonary Bypass Meeting does not preclude you from submitting and presenting at the SCA, IARS or ASA Annual Meetings. Instructions for Submitting Abstracts 1. Only abstracts submitted on the proper form will be considered. Abstracts are limited to one page. 2. Please use the format shown on the enclosed example (see page 2 of this document). 3. Font size smaller than 10 point will not be accepted. 4. All abstracts must be received by January 29, 2010. 5. All images need to be attached as a separate JPEG File. 6. Ensure that the Disclosure Form is completed and returned with abstract. (Only Presenting Author needs to complete this form) 7. Complete application below. 8. Create a blinded copy on page 4. A. Copy only the Title and Abstract into their respective boxes. B. Leave the Author(s) and Affiliation lines blank 9. Save this document. 10. E-mail the file to sca@societyhq.com. Subject line should read: Abstract Submission – Presenting Authors Last Name (i.e. – “Abstract Submission – Smith”). If your abstract contains any images, please include it as a separate attachment to your email. Please make sure all figures, images, etc. are black and white. 11. These documents will be processed electronically. The blinded copy on Page 4 will be submitted to the judges. If your document does not strictly follow the proper format it will not be processed. 12. If you have not received an email receipt confirmation within two (2) working days, please notify the SCA Administrative Office at sca@societyhq.com or 804-282-0084. Abstract Submission Application 1. Title of Abstract: 2. Name of Author(s) and Institution. Include specialty preference and title(s) of each author. Presenting author should be listed as (a). a. b. c. d. e. f. g. h. 3. Complete name and address of where correspondence should be sent: Address: Phone: Fax: Email: 4. If human subjects were used, do you agree or disagree with the following statement: "My study satisfies the requirements of my institution or organization regarding the use of human subjects in scientific research." ___ Agree ___ Disagree (mark your choice with an X) Presentation type: All accepted abstracts will be presented as posters. Duration of Cooling During Pediatric Cardiac Surgery Influences Cerebral Metabolism in Infant Author(s): WJ Greeley, FH Kern, SR Schulman, B. Baldwin, RM Ungerleider Affiliation: Harvard School of Medicine, Boston, MA Introduction: Recent clinical studies during pediatric cardiac surgery have demonstrated that rapid cooling negatively influences neuropsychologic outcome. (1, 2) In these studies, failure of hypothermia to adequately suppress cerebral metabolism (CMR02) prior to deep hypothermia circulatory arrest (DHCA) was speculated to be the mechanism for injury. Other experimental studies have suggested that the brain cools unevenly during cardiopulmonary bypass (CPB). (3) We therefore, hypothesized that a longer duration of cooling would enhance more homogeneous brain cooling and promote suppression of CMR02 prior to DHCA, and improve recovery of CMR02 after CPB. Methods: After Institutional Review Board approval and informed consent, 60 neonates and infants undergoing cardiac surgery with CPB and deep hypothermic circulatory arrest (DHCA) were randomized to one of two groups. Group A (n=30) were exposed to prolonged CPB cooling of 20 min prior to DHCA, and compared to a cohort group (B) of another 30 patients undergoing standardized cooling to a nasopharyngeal temperature of 18°C and then arrested, where a shorter duration of cooling is customary. Anesthetic management consisted of midazolam (75 mcg/kg load; and 0.75 mcg/kg/min infusion), fentanyl (25 mcg/kg; and 1 mcg/kg/hr infusion) and pancuronium as required for neuromuscular blockade. Nonpulsatile CPB pump flow with a membrane oxygenator was maintained at the rate of 150 ml/kg/min during cooling and rewarming, and alpha-stat blood gas management was used. Cerebral blood flow (CBF), CMR02, and cerebral oxygen extraction (A-V02) were measured before, during and after CPB. Intragroup data were analyzed using ANOVA for repeated measurements and intergroup data were analyzed using unpaired T-tests, with significance assumed at the P<0.05 level. Results: There was no intergroup difference with respect to age, congenital heart lesion, surgical procedure, or starting hematocrit. Duration of cooling was significantly longer in Group A vs Group B (20.2±1.9 vs 11.6±2.0 min. respectively; p<0.01). CMR02 and A-V02 difference were significantly lower in Group A compared to B after cooling (Table). Despite greater CMR02 suppression in A, the recovery of CMRO2 after DHCA was not significantly different from Group B (Table). Discussion: We conclude that increasing the duration of CPB cooling to 20 minutes prior to DHCA in infants optimizes cerebral metabolic suppression. We speculate that increasing the duration of cooling promotes more homogeneous cooling of the brain and recommend its application during cardiac surgery. However, despite the enhanced metabolic suppression due to prolonged cooling, the recovery of CMR02 after DHCA is still abnormal, suggesting that hypothermic protection with enhanced cooling may still be insufficient as a sole protective measure when DHCA is used. TABLE I CMRO2 I II III A 1.2±0.40 0.08±0.04* 0.52±0.25# B 1.2±0.33 0.19±0.10 0.65±0.34# A-V 02 A 6.0±1.4 0.8±0.30* 4.4±1.4# B 5.7±1.3 1.7±0.50 5.0±2.0 02Ext A 40%±21 11%±5* 37%±15 B 45%±13 19%±6 39%±18 A=Prolonged cooling group; B=Control group; I=Baseline, warm; II=Cold, CPB; III=Rewarmed, Post-CPB; CMR02=Cerebral metabolic rate, oxygen (ml/100gm/min); A-V 02=Cerebral AV 02 difference; 02 Ext=Cerebral oxygen extraction ratio (%). Mean values ±S.D.; *p<0.05, grp A vs B; #p<0.05, stage III vs I. Refs: 1. Bellinger D. et al., Pediatrics 1989 2. Greeley W.J. et al., J Thorac Cardiovsc Surg, 1991 3. Hindman, B.J. et al., Anesthesiology, 1992 TITLE: AUTHOR(S): AFFILIATION(S): ABSTRACT BODY: TITLE: AUTHORS: <BLINDED COPY LEAVE BLANK> AFFILIATION: <BLINDED COPY LEAVE BLANK> ABSTRACT BODY Disclosure of Relevant Financial Relationships (Only Presenting Author needs to complete this form) SCA 15th Annual Update on Cardiopulmonary Bypass Meeting March 21-26, 2010 • Whistler, British Columbia, Canada Name: Content of Activity: Abstract Presentation (Poster) Date of Activity: March 24, 2010 First: List the names of proprietary entities producing health care goods and services, with the exception of non-profit or government organizations and non-health care related companies with which you or your spouse/partner have, or have had, a relevant financial relationship within the past 12 months. For this purpose we consider the relevant financial relationships of your spouse or partner that you are aware of to be yours. Second: Describe what you or your spouse/partner received (ex: salary, honorarium, etc). SCA does NOT want to know how much you received. Third: Describe your role. Nature of Relevant Financial Relationship (Include all those that apply) Commercial Interest What was received For What Role? Honorarium Speaker Example: Company ‘X’ I do not have any relevant financial relationships with any commercial interests. Signature Date Example terminology What was received: Salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Role(s): Employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and ‘other activities (please specify). Glossary of Terms Commercial Interest The ACCME defines a “commercial interest” as any proprietary entity producing health care goods or services, with the exemption of non-profit or government organizations and non-health care related companies. Financial relationships Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner. Relevant financial relationships ACCME focuses on financial relationships with commercial interests in the 12-month period preceding the time that the individual is being asked to assume a role controlling content of the CME activity. ACCME has not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship. The ACCME defines “’relevant’ financial relationships” as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Conflict of Interest Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of a commercial interest with which he/she has a financial relationship. CME REQUIREMENTS The Accreditation Council for Continuing Medical Education (ACCME) accredits SCA. As such, we have made the choice to meet the ACCME’s expectations for our practice of continuing medical education. Our accreditation is important to us. We look forward to working together to provide CME at the highest standard. SCA has implemented a process where everyone who is in a position to control the content of an education activity has disclosed to us all relevant financial relationships with any commercial interest. In addition, should it be determined that a conflict of interest exists as a result of a financial relationship you may have, this will need to be resolved prior to the activity. This information is necessary in order for us to be able to move to the next steps in planning this CME activity. If you refuse to disclose relevant financial relationships, you will be disqualified from being a part of the CME activity. The Commercial Support Standards also require that your presentation is free of commercial bias and that any information regarding commercial products/services be based on scientific methods generally accepted by the medical community. When discussing therapeutic options, it is our preference that you use only generic names. If it is necessary to use a trade name, then those of several companies must be used. Further, should your presentation include discussion of any unlabeled/investigational use of a commercial product, you are required to disclose this to the participants. Should you determine that you cannot comply with these requirements or any of the provisions, please contact the SCA Administrative Office as soon as possible. It is the Society’s policy to conduct post-activity evaluations. These evaluations ask participants to indicate the appropriateness of presentations to their specific practices, if the presentations satisfied the stated objectives, if they were satisfied with the faculty presentations and if there was any evidence of commercial bias. The results of these evaluations are used to plan future CME activities and are shared with the faculty. Once again thank you for your willingness to participate in this event. We have worked hard to develop a program which will meet the expressed needs of our expected participants, who we anticipate will come from the US, Canada and overseas. We have specifically promoted this educational activity to the SCA, Canadian Society of Clinical Perfusionists, American Society of Extacorporeal Technology, and the Japanese Society of Cardiovascular Anesthesiologists memberships. A) Generic and Trade Names – Presentations must give a balanced view of therapeutic options. Presenter’s use of general names will contribute to this impartiality. If trade names are used, those of several companies should be used rather than only that of a single supporting company. B) Unlabeled Uses of Products – When an unlabeled use of a commercial product, or an investigational use not yet approved for any purpose is discussed during an educational activity, the presenter is required to disclose that the product is not labeled for the use under discussion or that the product is still investigational. My presentation will comply with sections A-B above. SIGNATURE:________________________________________ DATE:____________________ PLEASE RETURN TO THE SCA ADMINISTRATIVE OFFICE WITH YOUR ABSTRACT SUBMISSION