{
    "abstract": "Congenital heart disease affects 1% of US births, with many babies requiring major cardiothoracic surgery under cardiopulmonary bypass (CPB), exposing the more critical patients to neurodevelopmental impairment. Optimal surgical parameters to minimize neuronal injury are unknown. We used proton magnetic resonance spectroscopy (\nTwo-week old piglets (N\u00a0=\u00a017) were put on a CPB pump and placed in a 3-T magnetic resonance imaging to study brain metabolism during CPB. Dynamic single-voxel \nAll animals showed a transitory temperature-dependent increase in blood ammonia (P\u00a0<\u00a0.001) immediately after restart of whole-body perfusion. In contrast, metabolic processing of brain ammonia, as detected by an increased \nSerial ",
    "authors": [
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif. Electronic address: spielman@stanford.edu.",
            "firstname": "Daniel",
            "initials": "D",
            "lastname": "Spielman"
        },
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Meng",
            "initials": "M",
            "lastname": "Gu"
        },
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Hunter",
            "initials": "H",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Shie-Chau",
            "initials": "SC",
            "lastname": "Liu"
        },
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Ralph",
            "initials": "R",
            "lastname": "Hurd"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Kirk",
            "initials": "K",
            "lastname": "Riemer"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif; Department of Pediatric Cardiothoracic Surgery, MUSC Shawn Jenkins Children's Hosptital, Charleston, SC.",
            "firstname": "Kenichi",
            "initials": "K",
            "lastname": "Okamura"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Masafumi",
            "initials": "M",
            "lastname": "Shibata"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Paul",
            "initials": "P",
            "lastname": "Shuttleworth"
        },
        {
            "affiliation": "Department of Anesthesia, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Zachary",
            "initials": "Z",
            "lastname": "Kleiman"
        },
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Karla",
            "initials": "K",
            "lastname": "Epperson"
        },
        {
            "affiliation": "Department of Radiology, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Kevin",
            "initials": "K",
            "lastname": "Epperson"
        },
        {
            "affiliation": "Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.",
            "firstname": "Frank",
            "initials": "F",
            "lastname": "Hanley"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.jtcvs.2025.01.016",
    "journal": "The Journal of thoracic and cardiovascular surgery",
    "keywords": [
        "ammonia",
        "antegrade cerebral perfusion",
        "brain metabolism",
        "cardiopulmonary bypass",
        "deep hyperthermic circulatory arrest",
        "magnetic resonance spectroscopy",
        "neonatal"
    ],
    "methods": null,
    "publication_date": "2025-01-25",
    "pubmed_id": "39855339",
    "results": "All animals showed a transitory temperature-dependent increase in blood ammonia (P\u00a0<\u00a0.001) immediately after restart of whole-body perfusion. In contrast, metabolic processing of brain ammonia, as detected by an increased ",
    "title": "The circulatory arrest recovery ammonia problem (CARAP) hypothesis: A proton magnetic resonance spectroscopy (",
    "xml": "<Element 'PubmedArticle' at 0x78850357dfd0>"
}