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Correspondence  |   January 2006
Of Mice and Men and Type II Errors
Author Affiliations & Notes
  • Sulpicio G. Soriano, M.D.
    *
  • *Children’s Hospital Boston, Boston, Massachusetts.
Article Information
Correspondence
Correspondence   |   January 2006
Of Mice and Men and Type II Errors
Anesthesiology 1 2006, Vol.104, 206. doi:
Anesthesiology 1 2006, Vol.104, 206. doi:
In Reply:—
Dr. Hartung is correct in pointing out that we erroneously stated that there were “no significant differences between the study groups and population norms.”1 The purpose of our letter to the editor was not to disprove the hypothesis that “data obtained in rodents apply to humans” in the context of anesthetic neurotoxicity and the developing brain. This phenomenon should be examined in a formal prospective case–control study in humans with validated outcome measures. The point that we wanted to make in the graph was that, despite the severity of cardiac lesions and the operative conditions (i.e.  , hypoxia,2 prolonged anesthesia/sedation, and circulatory arrest/support), the mean neurocognitive outcomes at 4 and 8 yr were somewhat lower but within the normal range of the normative values (100 ± 15) of the general population.3,4 Delayed repair of congenital heart disease is associated with progressive decrement of cognitive function and justifies early surgical intervention in neonates.5 These data are not a direct test of the neurocognitive effects of prolonged anesthesia/sedation in human neonates but should provide some impetus for further investigations. To paraphrase Shakespeare in Love’s Labour’s Lost  , “Beauty is bought by judgment of the eye, not utt’red by base sale of chapmen’s tongues.”6 We acknowledge our utterance of incorrect statistical analysis of existing data and stand corrected. However, there are no existing human experimental data that clearly demonstrate the neurotoxic effect of anesthetics in pediatric patients.
*Children’s Hospital Boston, Boston, Massachusetts.
References
Soriano SG, Anad KJ, Rovnaghi CR, Hickey PR: Of mice and men: Should we extrapolate rodent experimental data to the care of human neonates? Anesthesiology 2005; 102:866–8Soriano, SG Anad, KJ Rovnaghi, CR Hickey, PR
Bass JL, Corwin M, Gozal D, Moore C, Nishida H, Parker S, Schonwald A, Wilker RE, Stehle S, Kinane TB: The effect of chronic or intermittent hypoxia on cognition in childhood: A review of the evidence. Pediatrics 2004; 114:805–16Bass, JL Corwin, M Gozal, D Moore, C Nishida, H Parker, S Schonwald, A Wilker, RE Stehle, S Kinane, TB
Bellinger DC, Wypij D, Kuban KC, Rappaport LA, Hickey PR, Wernovsky G, Jonas RA, Newburger JW: Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 1999; 100:526–32Bellinger, DC Wypij, D Kuban, KC Rappaport, LA Hickey, PR Wernovsky, G Jonas, RA Newburger, JW
Bellinger DC, Wypij D, du Duplessis AJ, Rappaport LA, Jonas RA, Wernovsky G, Newburger JW: Neurodevelopmental status at eight years in children with dextro-transposition of the great arteries: The Boston Circulatory Arrest Trial. J Thorac Cardiovasc Surg 2003; 126:1385–96Bellinger, DC Wypij, D du Duplessis, AJ Rappaport, LA Jonas, RA Wernovsky, G Newburger, JW
Newburger JW, Silbert AR, Buckley LP, Fyler DC: Cognitive function and age at repair of transposition of the great arteries in children. N Engl J Med 1984; 310:1495–9Newburger, JW Silbert, AR Buckley, LP Fyler, DC
Shakespeare W: Love’s Labour’s Lost. Act II, Scene i. 1598