Incidence and impact of silent brain lesions after coronary artery bypass grafting

Tachibana, Hitoshi; Hiraoka, Arudo; Saito, Kazuya; Naito, Yasuhisa; Chikazawa, Genta; Tamura, Kentaro; Totsugawa, Toshinori; Yoshitaka, Hidenori; Sakaguchi, Taichi

doi:10.1016/j.jtcvs.2019.09.162

Cited by 17 publications

(21 citation statements)

References 33 publications

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“…In the case of a variation in heart rate and oxygen saturation more than 20% from baseline, the intervention was discontinued. 1 Patients in the control group received the routine hospital cardiac ICU care including adequate fluid resuscitation, appropriate inotropic support, ventilator management, and chest physiotherapy. All patients received intravenous paracetamol to relieve postoperative pain and nitroglycerin to control blood pressure.…”

Section: Methodsmentioning

confidence: 99%

“…In spite of progress in the surgical procedure, anesthesia management, and postoperative intensive care, CABG patients are still at high risk of postoperative delirium. 1 , 2 Studies have revealed that postoperative delirium has an adverse impact on postoperative outcomes including mortality, nosocomial complications, and cognitive decline. 3 Delirium is a neurological condition typified by acute cognitive dysfunction, variation of mental status, carelessness, and severe disturbance of consciousness.…”

Section: Introductionmentioning

confidence: 99%

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Early mobilization reduces delirium after coronary artery bypass graft surgery

Shirvani

Naji

Davari

et al. 2020

Asian Cardiovasc Thorac Ann

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Background Postoperative delirium is common in patients undergoing coronary artery bypass grafting, characterized by cognitive decline. This study aimed to evaluate the effect of early planned mobilization on delirium after coronary artery bypass grafting. Methods This double-blind randomized clinical trial enrolled 92 consecutive patients who underwent coronary artery bypass grafting from September to December 2018. The patients were divided into two groups of 46: a mobilization protocol was applied in the intervention group in the first 2 days after surgery; the control group received routine nursing care only. Demographic data, medical records, and Neecham confusion scores were analyzed. Results Patients in the control group used cigarettes (31.1% vs. 11.1%, p = 0.020) and opium poppy for recreation (35.6% vs. 8.9%, p = 0.002) more frequently, had longer intubation times (11.91 ± 3.87 vs. 10.23 ± 2.71 h, p = 0.020), and fewer blood components infused (15.6% vs. 33.3%, p = 0.05). More patients in the intervention group had normal function on the 2nd postoperative day compared to the control group (25 vs. 2, respectively, p = 0.001). The intervention group had significantly higher Neecham scores on postoperative day 2 (22.49 ± 2.03 vs. 26.82 ± 2.10, p = 0.001). Multivariable analysis showed significant associations between Neecham score and age ( p = 0.022), ejection fraction ( p = 0.015), myocardial infarction ( p = 0.016), systolic pressure ( p = 0.009), and diastolic pressure ( p = 0.008). Conclusions Early planned mobilization was effective in reducing postoperative delirium in patients undergoing coronary artery bypass grafting.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Early mobilization reduces delirium after coronary artery bypass graft surgery

Shirvani

Naji

Davari

et al. 2020

Asian Cardiovasc Thorac Ann

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show abstract

“…This is important because the etiology of post‐CABG stroke is thought to be diverse as it includes air embolism, hypotensive episodes, or atherosclerotic disease. Tachibana et al 3 are to be commented as they evidenced how aortic cross‐clamping versus side‐clamping versus beating‐heart operations affect the stroke rate. In the study by Pahwa et al, 1 these differences were not included.…”

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confidence: 99%

Success in long‐term outcome after cardiac surgery: Rise from an uncomplicated immediate postoperative course

et al. 2021

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“…It is in this context that we read with interest the paper by Tachibana and colleagues 5 in this issue of the Journal in which the authors describe the incidence and impact of ''silent'' brain lesions after CABG. The authors report their experience with 104 patients who underwent elective and isolated first-time CABG over a 2-year study period.…”

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confidence: 99%