Postoperative neuropsychological dysfunction and cerebral oxygenation during cardiac surgery.

Details

Serval ID
serval:BIB_213777192699
Type
Article: article from journal or magazin.
Collection
Publications
Title
Postoperative neuropsychological dysfunction and cerebral oxygenation during cardiac surgery.
Journal
Thoracic and Cardiovascular Surgeon
Author(s)
Nollert G., Möhnle P., Tassani-Prell P., Uttner I., Borasio G.D., Schmoeckel M., Reichart B.
ISSN
0171-6425 (Print)
ISSN-L
0171-6425
Publication state
Published
Issued date
1995
Volume
43
Number
5
Pages
260-264
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
In 41 patients undergoing cardiac operations with extracorporeal circulation, oxidized cytochrome a,a3(CtO2), deoxygenated hemoglobin (Hb), and oxygenated hemoglobin (HbO2) were measured in brain tissue by near-infrared spectrophotometry (NIRS) intraoperatively. Monitoring also included electroencephalography (EEG) and jugular-bulb venous saturation (SBJO2). All operations were performed using membrane oxygenators, moderate hypothermia (26-28 degrees C) and pH alpha-stat management. During cardiopulmonary bypass (CPB) CtO2 and HbO2) were reduced, reaching minimal values when rewarming was instituted. At the end of the operation CtO2 and HbO2 had regained initial levels. During CPB, arterial PCO2, pH, and temperature were closely related to CtO2 (r = 1000, r = -0.964 and 0.929 respectively; p < 0.001, p < 0.001, and p < 0.003 respectively). Neuropsychological testing by the Mini-Mental-State Test indicated reversible postoperative neuropsychological deficits in four patients. There patients had a lower CtO2 minimum compared to those without these deficits (-4.5 mumol/L v. -0.7 mumol/L; p = 0.036). These findings support the hypothesis that neuropsychological deficits in patients after cardiac surgery can be caused by intraoperative cerebral hypoxia.
Keywords
Adult, Aged, Blood Gas Analysis, Brain/metabolism, Cardiac Surgical Procedures/adverse effects, Delirium, Dementia, Amnestic, Cognitive Disorders/diagnosis, Delirium, Dementia, Amnestic, Cognitive Disorders/etiology, Electron Transport Complex IV/metabolism, Female, Hemoglobins/metabolism, Humans, Hypoxia, Brain/diagnosis, Hypoxia, Brain/etiology, Male, Mental Status Schedule, Middle Aged, Monitoring, Intraoperative, Oxyhemoglobins/metabolism, Spectrophotometry, Infrared
Pubmed
Web of science
Create date
13/01/2014 16:47
Last modification date
20/08/2019 12:57
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