Neurological Complications After Coronary Artery Bypass Grafting Related to the Performance of Cardiopulmonary Bypass

Ganushchak, Youri M.; Fransen, Erik J; Visser, Cees A.; Jong, Dick S de; Maessen, Jos G.

doi:10.1378/chest.125.6.2196

Cited by 39 publications

(21 citation statements)

References 27 publications

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“…Based on these principles, the authors of this study applied the score and compared the total value with the chance of development the following outcomes: postoperative stroke, encephalopathy, prolonged length of hospital stay and death. Subsequently with the objective of verifying its predictive power, it was compared with other known risk factors for this surgery, which are not included in its variables, but are cited as predisposing these complications, which are: cardiopulmonary bypass time, length of aortic clamping and the duration of mechanical ventilation [23,24].…”

Section: Discussionmentioning

confidence: 99%

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Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery

Nina¹,

Rocha²,

Rodrigues³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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Introduction: Neurological dysfunction is a feared postoperative morbidity of cardiac surgery, an important cause of death and increased spending in hospitals. Its prediction, however, is still uncertain.Objective: To assess the applicability of a preoperative score as a predictor of neurological dysfunction after coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB).Methods: Prospective study that evaluated 77 patients who underwent CABG from February to October 2011. Using the score CABDEAL (creatinine, age, body mass index, diabetes, emergency surgery, abnormality on ECG, lung disease), patients were grouped into high (CABDEAL > 4) and low risk (CABDEAL<4). The predictive value of the score was compared with intraoperative and postoperative variables (aortic clamping time, CPB and ventilation time) as predictors of encephalopathy and stroke. Data were analyzed with descriptive statistics and compared with the Fisher exact test. ROC curve analysis was performed to evaluate the accuracy of the model for the neurological outcomes. It was considered the significant value P<0.05.Results: The mortality rate was 2.6% (n=2). There were 2 episodes of stroke (2.6%) and 12 (15.5%) of encephalopathy. High risk CABDEAL (P=0.0009), ventilation time (P=0.014), CPB time (P=0.02) and aortic clamping time (P=0.006) were significantly associated with encephalopathy. The aortic clamping time was also associated with stroke (P=0.03) and Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery Bras Cir Cardiovasc 2012;27(3):429-35 death (P=0.006). CABDEAL score showed the largest area under the ROC curve rather than others variables.CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery RevConclusion: In this study, the CABDEAL score stood out as the best predictor of encephalopathy after CABG when compared to the others intraoperative variables.Keywords: Myocardial revascularization. Risk assessment. Morbidity. Brain damage. Resumo Introdução: As complicações neurológicas são temidas no pós-operatório das cirurgias cardíacas, sendo importante causa de óbito e de gastos hospitalares. Sua predição ainda é incerta.Objetivo: Avaliar a aplicabilidade de um escore pré-operatório como preditor de disfunção neurológica no pós-operatório de revascularização miocárdica (RM) com circulação extracorpórea (CEC). Métodos

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Section: Discussionmentioning

confidence: 99%

“…The 2.6% occurrence of stroke in this study did not present significant correlation with the high value of the score. However, it was associated to prolonged periods of CPB and aortic clamping [24]. There are few studies on the technique of clamping influencing the occurrence of neurological events.…”

Section: Discussionmentioning

confidence: 99%

Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery

Nina¹,

Rocha²,

Rodrigues³

et al. 2012

Revista Brasileira De Cirurgia Cardiovascular

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“…A low haemoglobin concentration or low haematocrit reduces tissue oxygen delivery and is associated with tissue hypoxia 28 and injury affecting the brain, heart and kidneys. 29,[199][200][201] In an apparent paradox, however, reversal of anaemia during CPB with red cell transfusion is associated with a further increase in the risk of developing organ failure. 29 It is unclear whether this additional risk is attributable to transfusion or the effects of unmeasured confounders.…”

Section: The Clinical Problemmentioning

confidence: 99%

Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials

Murphy

Mumford

Rogers

et al. 2017

Programme Grants Appl Res

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This report should be referenced as follows:Murphy GJ, Mumford AD, Rogers CA, Wordsworth S, Stokes EA, Verheyden V, et al. Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials. Programme Grants Appl Res 2017;5(17). Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10384. The contractual start date was in July 2008. The final report began editorial review in July 2016 and was accepted for publication in April 2017. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not ...

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“…Vücudun oksijen dengesini belirleyen; baypas sıcaklığı, yeniden ısınma, pompa akımı, perfüzyon basınçları ve diyabet gibi otoregülasyonu bozabilen yandaş hastalıkların varlığı ya da ileri yaş gibi faktörler de kritik hemoglobin düzeyini doğrudan etkilemektedir (19,30,31) .…”

Section: Anemi Ve Riskleriunclassified

Transfusion Triggers in Cardiac Surgery

Güler¹

2012

GKDA Derg

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Neurological Complications After Coronary Artery Bypass Grafting Related to the Performance of Cardiopulmonary Bypass

Cited by 39 publications

References 27 publications

Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery

Assesment of CABDEAL score as predictor of neurological dysfunction after on-pump coronary artery bypass grafting surgery

Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials

Transfusion Triggers in Cardiac Surgery

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