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Shaw PJ, Bates D, CartIidge NEF, et al: Neurologic and nemopsychological morbidity following major surgery. Stroke 18:700-707, 1987

In a prospective study, 312 patients undergoing coro- nary artery bypass (CABG) surgery were compared to 50 patients undergoing major peripheral vascular surgery for incidence of neurologic and neuropsychological complica- tions. Neuropsychologic evaluation included the Wechsler Memory Scale, sections of the Wechsler Adult Intelligence Scale, and the Halstead Reitan Trail Making Part B tests. The incidence of complications was significantly higher in the CABG patients: 61% Y 18% for neurologic and 79% Y 31% for neuropsychological problems. In the CABG group psycho- motor speed, attention span, new learning ability, concentra- tion, and auditory short-term memory deteriorated most. Factors such as type of anesthesia, incidence of intra- and postoperative hypotension, and preoperative neurologic abnormalities were similar in both groups. However, details of cardiopulmonary bypass (flows, pressures, use of filters, type of oxygenator, etc), to which the authors attribute the differences in neurologic function between the two groups, are unfortunately not detailed.

Vicari AM, Guisti MC, Luoni R, et al: Platelet function and thromhin activity in patients with recent cerebral transient ischemic attacks. Stroke 18:892-895,1987

Hyperactive platelets and enhanced thrombin activity were noted to be present 2 to 12 weeks after a transient ischemic attack (TIA) in patients without atherosclerosis or cerebral ischemia. Platelets from patients having TIA gener- ated more thromboxane B, (the metabolite of thromboxane Aa, a measure of platelet function). Plasma beta-thrombo- globulin (an index of platelet activation) concentrations were higher in patients with TIA than in controls. Finally, plasma fibrinopeptide A (an indicator of thrombin activity because it is one of the oligopeptides cleaved by thrombin from fibrino- gen) was significantly higher after TIA.

CAROL L. LAKE

Leitman IM, Paul1 DE, Barie PS, et al: Intra-abdominal complications of cardiopulmo- nary bypass operations. Surg Gynecol Obstet 165:251-254,1987

In a retrospective study of 6,452 patients undergoing cardiac surgery over a IO-year period (1976 to 1986), 60 intra-abdominal complications occurred in 51 patients (0.94%) within 6 weeks postoperatively. Complications included gastrointestinal bleeding (most common-33% inci- dence), intestinal ischemia (27% incidence), acute cholecysti- tis (18% incidence), pancreatitis, small bowel obstruction, perforated ulcer, hepatic necrosis, and splenic laceration. Risk factors included prolonged time on cardiopulmonary bypass, need for positive inotropic agents or intra-aortic balloon counterpulsation, advanced age, emergency surgery, and systolic blood pressure less than 70 mmHg for 30 minutes. Mortality was 59%. Both the frequency, type, and mortality of these complications are similar to those previ- ously reported.

ACKNOWLEDGMENT

The papers reviewed for this issue included those published in the following journals: Acra Anaesthesiologica Scandinavica, American Heart Journal, American Journal of Cardiology, American Journal of Physiology, American Review of Respiratory Disease, Anaesthesia, Anaesthesist. Anesthesia and Analgesia, Anesthesiology, Angiology, Annals of Thoracic Surgery, Archives of Surgery, Blut, British Journal of Anaesthesia, Cardiovascular Research, Clinical Pharmacology and Therapeutics, Critical Care Medicine, Chest, Circulation, European Heart Journal, Hypertension, Journal of the American College of Cardiolo- gy, Journal of Applied Physiology, Journal of Cardiac Surgery, Journal of Cardiovascular Pharmacology. Journal of Cardiovascular Surgery. Journal of Cerebral Blood Flow and Metabolism, Journal of Clinical Monitoring, Journal of Thoracic and Cardiovascular Surgery, Journal of Trauma, Journal of Vascular Surgery, New England Journal of Medicine, Progress in Cardiovascular Disease, Science, Stroke; Surgery, Gynecology, and Obstetrics; Thorax, Transfusion, and Vascular Surgery.