Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass

Background: This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG). Methods: Over a 6-month period, GME...

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Bibliographic Details
Published in:	Perfusion Vol. 28; no. 3; pp. 256 - 262
Main Authors:	Doganci, S, Gunaydin, S, Kocak, O Murat, Yilmaz, S, Demirkilic, U
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-05-2013 Sage Publications Ltd
Subjects:	Aged Aged, 80 and over Cardiopulmonary Bypass - adverse effects Cardiopulmonary Bypass - methods Cardiopulmonary Bypass - psychology Cognition Embolic Protection Devices Female Follow-Up Studies Humans Male Middle Aged neurocognitive deficits embolism coronary artery bypass grafting
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Summary:	Background: This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG). Methods: Over a 6-month period, GME activity was monitored in 102 Euroscore 6+ patients during cardiopulmonary bypass (CPB) with a conventional 32-micron arterial filter by non-invasive, real-time ultrasonic device. Cognitive tests; line bisection, the Stroop test, finger tapping, and the Rey Auditory Verbal Learning Test were performed at baseline, postoperative one week and postoperative one month. Results: The distribution of GME activity showed that there were three groups of patients: >500 total emboli (n = 38); 250 to 500 emboli (n = 30) and <250 emboli (n = 34) at a detection level of 2% of the circuit diameter on the arterial side. Line bisection, the Stroop test and finger tapping were impaired significantly in >500 emboli patients versus control (<250 emboli) in postoperative week one, but resolved in one month. Conclusions: Correlation between intraoperative GME intensity and neurocognitive tests suggests that the level of GME might have a role in determining the psychological outcome after CABG with CPB.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0267-6591 1477-111X
DOI:	10.1177/0267659112470693