Neuropsychological Changes after Cardiopulmonary Bypass for Coronary Artery Bypass Grafting

Wimmer‐Greinecker, Gerhard; Matheis, G.; Brieden, M; Dietrich, Markus; Oremek, G. M.; Westphal, K.; Br, Winkelmann; Moritz, Anton

doi:10.1055/s-2007-1010226

Cited by 40 publications

(20 citation statements)

References 4 publications

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“…Wimmer-Greinecker et al 21 reported no association between neuropsychological function and NSE and S-100B serum concentrations in patients undergoing CABG. In the latter study, however, no significant neuropsychological change after surgery could be observed.…”

Section: Discussionmentioning

confidence: 98%

Neurobehavioral Outcome Prediction After Cardiac Surgery

Herrmann

Ebert

Galazky

et al. 2000

Stroke

152

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Background and Purpose-The goal of the present study was to investigate the predictive value of neurobiochemical markers of brain damage (protein S-100B and neuron-specific enolase [NSE]) with respect to the short-and long-term neuropsychological outcomes after cardiac surgery with cardiopulmonary bypass (CPB). Methods-We investigated 74 patients who underwent elective CABG or valve replacement surgery and who showed no severe neurological deficits after surgery. Patients were investigated with a standardized neurological examination and a comprehensive neuropsychological and neuropsychiatric assessment 1 to 2 days before surgery, 3 and 8 days after surgery, and 6 months later. Serial venous blood samples were taken preoperatively and 1, 6, 20, and 30 hours after skin closure. Protein S-100B and NSE were analyzed with immunoluminometric assays. Results-Patients with severe postoperative neuropsychological disorders showed a significantly higher and longer release of neurobiochemical markers of brain damage. Patients who presented with a delirium according to DSM-III-R criteria 3 days after surgery had significantly higher postoperative S-100B serum concentrations. Multivariate analysis (based on postoperative NSE and S-100B concentrations and age of patients, type of operation, length of cross-clamp and perfusion time, and intraoperative and postoperative oxygenation) identified NSE and S-100B concentrations 6 to 30 hours after skin closure as the only variables that contributed significantly to a predictive model of the neuropsychological outcome. NSE, but not S-100B, release was significantly higher in patients undergoing valve replacement surgery. Conclusions-Postoperative serum concentrations and kinetics of S-100B and NSE have a high predictive value with respect to the early neuropsychological and neuropsychiatric outcome after cardiac surgery. The analysis of NSE and S-100B release might allow insight into the underlying pathophysiology of brain dysfunction, thus providing a valuable tool to monitor and evaluate measures to improve cardiac surgery with CPB. (Stroke. 2000;31:645-650.)

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Section: Discussionmentioning

confidence: 98%

Neurobehavioral Outcome Prediction After Cardiac Surgery

Herrmann

Ebert

Galazky

et al. 2000

Stroke

152

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“…No entanto, tais disfunções tendem a ser temporárias e desaparecem entre 6 semanas a 6 meses, após a cirurgia (12,25) .…”

Section: Discussionunclassified

“…No entanto, durante os diálogos buscávamos investigar a presença daqueles problemas que são comuns nos primerios meses após a cirurgia (3)(4)(5)7,(10)(11)(12)(24)(25) .…”

Section: Introductionunclassified

Problemas Na Recuperação De Pacientes Submetidos À Cirurgia De Revascularização Do Miocárdio: O Acompanhamento Pelo Enfermeiro Durante O Primeiro Mês Após a Alta Hospitalar

Dantas

Aguillar

2001

Rev. Latino-Am. Enfermagem

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Dantas RAS, Aguillar OM. Problemas na recuperação de pacientes submetidos à cirurgia de revascularização do miocárdio: o acompanhamento pelo enfermeiro durante o primeiro mês após a alta hospitalar. Rev Latino-am Enfermagem 2001 novembro-dezembro; 9(6):31-6. PROBLEMS DURING THE RECOVERY OF PATIENTS FOLLOWING CORONARY ARTERY BYPASS SURGEY: THE FOLLOW-UP BY NURSES IN THE FIRST MONTH AFTER HOSPITAL DISCHARGEPatients may present problems after coronary artery bypass surgery and nurses play an important role in the detection of such problems. With the purpose to determine the problems of 25 patients during the first month after hospital discharge, they were followed up via telephone as well as when they returned to hospital. Content analyses of detailed nurses' recording revealed eight categories of problems. The most frequently related problems were related to the surgical incision site (76%), pharmacological therapy (28%), other pathologies (24%), mood alterations (20%) and sleep pattern disturbances (16%

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“…1,2) Although the mortality rate among patients developing neurological complications following CABG is 35.7%, this rate is only 4% in patients without neurological disorders. 3) Cerebral injury following CABG may manifest itself as an overt neurological complication or as a postoperative cognitive dysfunction (POCD) that may not be discernible under normal conditions.…”

Section: Introductionmentioning

confidence: 99%

“…3) Cerebral injury following CABG may manifest itself as an overt neurological complication or as a postoperative cognitive dysfunction (POCD) that may not be discernible under normal conditions. 1) Several studies that comparatively evaluated POCD using different techniques CABG have demonstrated rates between 9% and 44% for impaired cognitive functions. [4][5][6][7] This variation in reported rates most likely results from differences in the testing methodology and follow-up periods.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Circadian Melatonin Levels on Inflammation and Neurocognitive Functions Following Coronary Bypass Surgery

Geyik

Yıgıter

Akcali

et al. 2015

ATCS

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Purpose: In this study, the relationship between the plasma levels of melatonin and intercellular adhesion molecule-1 (ICAM-1), which plays role in several intercellular interactions including inflammatory and immune responses, and early neurocognitive functions associated with ischaemia-reperfusion injury during open heart surgery is examined. Methods: Forty patients who were to undergo elective coronary artery bypass grafting (CABG) were divided into two groups, those who underwent their operations at 8 AM (group I; n = 20) and those who underwent their operations at 1 PM (group II; n = 20). Blood samples were collected prior to surgery (S1), when the aortic cross clamp was removed (S2) and 4 (S3) and 24 h after the surgery (S4). Neuropsychiatric assessment was conducted one day before and seven days after surgery. Results: Melatonin levels measured during and after surgery were also significantly higher in Group 1. ICAM-1 levels were significantly lower in Group 1 at S2 and S3. Significant deterioration was observed in postoperative neurocognitive function compared with preoperative functions in Group 2 more than Group 1. Conclusion: We hypothesise that the greater preservation of neurocognitive functions in the morning patients is associated with elevated melatonin levels, which reduce the damage from ischaemia-reperfusion injury.

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Neuropsychological Changes after Cardiopulmonary Bypass for Coronary Artery Bypass Grafting

Abstract: Biochemical markers demonstrate significant postoperative cerebral injury during and immediately after CPB. However, CPB for CABG does not lead to marked impairment of neuropsychological scores, and clinically relevant neurological findings were observed in one patient only.

Cited by 40 publications

References 4 publications

Neurobehavioral Outcome Prediction After Cardiac Surgery

Neurobehavioral Outcome Prediction After Cardiac Surgery

Problemas Na Recuperação De Pacientes Submetidos À Cirurgia De Revascularização Do Miocárdio: O Acompanhamento Pelo Enfermeiro Durante O Primeiro Mês Após a Alta Hospitalar

The Effect of Circadian Melatonin Levels on Inflammation and Neurocognitive Functions Following Coronary Bypass Surgery

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