Cerebral injury during cardiopulmonary bypass: Emboli impair memory

Fearn, Shirley J.; Pole, R.; Wesnes, Keith; Faragher, E. B.; Hooper, Timothy L.; McCollum, Charles

doi:10.1067/mtc.2001.114099

Cited by 158 publications

(126 citation statements)

References 42 publications

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“…Even the patient with the highest embolic count (Ͼ500) was discharged with no detectable cognitive dysfunction. 6 The early concern regarding microembolism to the brain during cardiac surgery being a cause of postoperative cognitive dysfunction 26,27 has not been confirmed in more recent studies 28 and systematic reviews. 29,30 Liu et al 31 reported a median embolic count of 430 (range, 155-2088) in patients undergoing cardiac surgery with cardiopulmonary bypass against a median embolic count of 2 (range, 0 -66) in off-pump surgery but could show no difference in cognitive outcome.…”

Section: Discussionmentioning

confidence: 99%

Review of Transcranial Doppler Ultrasound to Detect Microemboli during Orthopedic Surgery

Silbert

Evered

Scott

et al. 2013

AJNR Am J Neuroradiol

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SUMMARY:Transcranial Doppler ultrasonography has been used to detect microemboli in the middle cerebral artery during orthopedic surgery. We conducted a comprehensive systematic literature review of transcranial Doppler ultrasonography in orthopedic surgery to evaluate its status in this setting. Fourteen studies were selected for qualitative analysis. The highest number of patients studied was 45; emboli were detected in all studies, occurring in 20%-100% of patients. Most embolic counts were below 10, but some high counts were noted. No study reported all the technical parameters of the transcranial Doppler ultrasonography. All studies assessed neurologic status, and 6 studies evaluated cognitive function postoperatively. No study identified an association between postoperative cognitive function and embolic count. Six studies sought the presence of right-to-left shunts. ABBREVIATIONS:HITS ϭ high-intensity transient signals; PFO ϭ patent foramen ovale; TCD ϭ transcranial Doppler ultrasonography; TEE ϭ transesophageal

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Section: Discussionmentioning

confidence: 99%

Review of Transcranial Doppler Ultrasound to Detect Microemboli during Orthopedic Surgery

Silbert

Evered

Scott

et al. 2013

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…To date, studies examining associations between surgery and delirium have investigated microemboli migration [149][150][151], hypoperfusion [64,137,[152][153][154], inflammatory responses [155][156][157], changes in hormone levels [158][159][160][161], and local and general anesthesia [64,133,162,163]. Gottesman and colleagues [152] hypothesized that a drop in the mean arterial pressure may put patients at risk for early cognitive dysfunction.…”

Section: Surgical Factors and Postoperative Cognitive Dysfunctionmentioning

confidence: 99%

Pathophysiology of Delirium in the Intensive Care Unit

Gunther

Morandi

Ely

2008

Critical Care Clinics

156

101

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“…43 A study with patients submitted to heart surgery demonstrated that hypoperfusion during the procedure was related to attention deficit. 35 This finding is also of relevance to patients undergoing carotid revascularization procedures, since these operations also involve a certain degree of hypoperfusion.…”

Section: Hemodynamic Changes and Repercussions For Cognitive Functionmentioning

confidence: 90%

“…26,35 By extrapolation, this finding might also be of relevance to carotid revascularization patients.…”

Section: 2829mentioning

confidence: 99%

The impact of carotid revascularization on cognitive function

et al. 2014

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The concept that carotid disease may compromise cognitive function was initially proposed by Fisher in 1951, based on an autopsy case. However, some topics involving cognitive function remain controversial, such as its correlation with carotid obstructive disease. So, the authors of this review evaluate the impact of carotid revascularization on cognitive function and the repercussions of the revascularization technique (carotid stenting vs. endarterectomy) chosen. It was clear from the literature reviewed that carotid stenosis is related to a decline in cognitive function over time. However, controversy still remains over the impact of carotid revascularization on cognitive function. With elation to the technique employed (carotid stenting vs. endarterectomy), the majority of studies found no difference between the two techniques in terms of overall cognitive outcome.Keywords: carotid stenosis; therapy; carotid endarterectomy; cognition. ResumoA noção de que a doença carotídea pode comprometer a função cognitiva foi proposta inicialmente por Fisher, em 1951, baseado em um caso de necropsia. Porém, alguns tópicos envolvendo a função cognitiva permanecem controversos, tais como sua correlação com a doença obstrutiva da carótida. Nesse sentido, os autores desta revisão buscam avaliar o impacto da revascularização carotídea e a repercussão da técnica de revascularização empregada (endarterectomia versus angioplastia carotídea) sobre a função cognitiva. A partir da literatura levantada, ficou claro que as estenoses carotídeas estão relacionadas com o declínio cognitivo ao longo do tempo, mas ainda há controvérsia no que se refere ao impacto da revascularização carotídea sobre a função cognitiva. Quanto à técnica empregada (angioplastia versus endarterectomia carotídeas), a maioria dos estudos não demonstrou distinção entre as duas técnicas quanto ao desfecho cognitivo geral. Palavras R E V I E W A R T I C L EGermano da Paz Oliveira, Ana Terezinha Guillaumon et al. stenting; cognitive changes; cognitive function. Results were restricted to articles published in English.Articles of interest identified by the initial search strategy were first independently assessed by two of the authors. In order to avoid the risk of excluding any studies that could be important to the review, a consensus meeting was held and then both reviewers chose all the titles they had identified as potentially relevant to the object of study, irrespective of whether or not an abstract was available. Once relevant titles had been selected, the full texts of the articles were acquired and each article was assessed against a protocol covering the following topics: study type, sample, type of intervention used, results observed. All longitudinal, prospective and retrospective articles, meta-analyses and review articles that met the criteria were included.Articles not yet published, comments and editorials, case reports and crosssectional studies were all excluded. Articles with very similar content were also excluded, giving priority to th...

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Cerebral injury during cardiopulmonary bypass: Emboli impair memory

Cited by 158 publications

References 42 publications

Review of Transcranial Doppler Ultrasound to Detect Microemboli during Orthopedic Surgery

Review of Transcranial Doppler Ultrasound to Detect Microemboli during Orthopedic Surgery

Pathophysiology of Delirium in the Intensive Care Unit

The impact of carotid revascularization on cognitive function

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