Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study

<p>Abstract</p> <p>Background</p> <p>Neurologic deficits after cardiac surgery are common complications. Aim of this prospective observational pilot study was to investigate the incidence of postoperative cognitive deficit (POCD) after cardiac surgery, provided that rel...

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Main Authors: Meybohm Patrick, Leiendecker Jörn, Serocki Götz, Stapelfeldt Claudia, Peters Sönke, Fudickar Axel, Steinfath Markus, Bein Berthold
Format: Article
Language:English
Published: BMC 2011-03-01
Series:BMC Anesthesiology
Subjects:
Online Access:http://www.biomedcentral.com/1471-2253/11/7
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author Meybohm Patrick
Leiendecker Jörn
Serocki Götz
Stapelfeldt Claudia
Peters Sönke
Fudickar Axel
Steinfath Markus
Bein Berthold
author_facet Meybohm Patrick
Leiendecker Jörn
Serocki Götz
Stapelfeldt Claudia
Peters Sönke
Fudickar Axel
Steinfath Markus
Bein Berthold
author_sort Meybohm Patrick
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Neurologic deficits after cardiac surgery are common complications. Aim of this prospective observational pilot study was to investigate the incidence of postoperative cognitive deficit (POCD) after cardiac surgery, provided that relevant decrease of cerebral oxygen saturation (cSO2) is avoided during cardiopulmonary bypass.</p> <p>Methods</p> <p>cSO2 was measured by near infrared spectroscopy in 35 patients during cardiopulmonary bypass. cSO2 was kept above 80% of baseline and above 55% during anesthesia including cardiopulmonary bypass. POCD was tested by trail making test, digit symbol substitution test, Ray's auditorial verbal learning test, digit span test and verbal fluency test the day before and 5 days after surgery. POCD was defined as a decline in test performance that exceeded - 20% from baseline in two tests or more. Correlation of POCD with lowest cSO2 and cSO2 - threshold were determined explorative.</p> <p>Results</p> <p>POCD was observed in 43% of patients. Lowest cSO2 during cardiopulmonary bypass was significantly correlated with POCD (p = 0.015, r2 = 0.44, without Bonferroni correction). A threshold of 65% for cSO2 was able to predict POCD with a sensitivity of 86.7% and a specificity of 65.0% (p = 0.03, without Bonferroni correction).</p> <p>Conclusions</p> <p>Despite a relevant decrease of cerebral oxygen saturation was avoided in our pilot study during cardiopulmonary bypass, incidence of POCD was comparable to that reported in patients without monitoring. A higher threshold for cSO2 may be needed to reduce the incidence of POCD.</p>
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spelling doaj.art-8d6faf22701d4a20a89404dfed5ef2cc2022-12-22T01:02:49ZengBMCBMC Anesthesiology1471-22532011-03-01111710.1186/1471-2253-11-7Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot studyMeybohm PatrickLeiendecker JörnSerocki GötzStapelfeldt ClaudiaPeters SönkeFudickar AxelSteinfath MarkusBein Berthold<p>Abstract</p> <p>Background</p> <p>Neurologic deficits after cardiac surgery are common complications. Aim of this prospective observational pilot study was to investigate the incidence of postoperative cognitive deficit (POCD) after cardiac surgery, provided that relevant decrease of cerebral oxygen saturation (cSO2) is avoided during cardiopulmonary bypass.</p> <p>Methods</p> <p>cSO2 was measured by near infrared spectroscopy in 35 patients during cardiopulmonary bypass. cSO2 was kept above 80% of baseline and above 55% during anesthesia including cardiopulmonary bypass. POCD was tested by trail making test, digit symbol substitution test, Ray's auditorial verbal learning test, digit span test and verbal fluency test the day before and 5 days after surgery. POCD was defined as a decline in test performance that exceeded - 20% from baseline in two tests or more. Correlation of POCD with lowest cSO2 and cSO2 - threshold were determined explorative.</p> <p>Results</p> <p>POCD was observed in 43% of patients. Lowest cSO2 during cardiopulmonary bypass was significantly correlated with POCD (p = 0.015, r2 = 0.44, without Bonferroni correction). A threshold of 65% for cSO2 was able to predict POCD with a sensitivity of 86.7% and a specificity of 65.0% (p = 0.03, without Bonferroni correction).</p> <p>Conclusions</p> <p>Despite a relevant decrease of cerebral oxygen saturation was avoided in our pilot study during cardiopulmonary bypass, incidence of POCD was comparable to that reported in patients without monitoring. A higher threshold for cSO2 may be needed to reduce the incidence of POCD.</p>http://www.biomedcentral.com/1471-2253/11/7Monitoringnear infrared spectroscopycardiopulmonary bypasscognitive symptoms
spellingShingle Meybohm Patrick
Leiendecker Jörn
Serocki Götz
Stapelfeldt Claudia
Peters Sönke
Fudickar Axel
Steinfath Markus
Bein Berthold
Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study
BMC Anesthesiology
Monitoring
near infrared spectroscopy
cardiopulmonary bypass
cognitive symptoms
title Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study
title_full Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study
title_fullStr Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study
title_full_unstemmed Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study
title_short Postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation: a prospective observational pilot study
title_sort postoperative cognitive deficit after cardiopulmonary bypass with preserved cerebral oxygenation a prospective observational pilot study
topic Monitoring
near infrared spectroscopy
cardiopulmonary bypass
cognitive symptoms
url http://www.biomedcentral.com/1471-2253/11/7
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