Status Epilepticus Due to Hyperfusion Injury Post Cardiac Surgery

Lipsman, Nir; Farb, Richard I.; Al‐Radi, Osman O.; Casaubon, Leanne K.

doi:10.1017/s0317167100010374

Cited by 1 publication

(1 citation statement)

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“…In addition to the endothelial dysfunction and disruption of the blood brain barrier, PRES occurs. (16)(17)(18) Out of ve patients who did not show any signi cant change nor acute lesion in the image, in this study, four patients survived with 11 ± 10 average days of ICU admission. Fifteen patients in cases of abnormalities detected in the brain image survived, the hospitalized days in the ICU was 10 ± 6 days in average.…”

Section: Discussionmentioning

confidence: 55%

Seizure After Cardiopulmonary bypass Surgery: A Retrospective Study

Kim

Jang²,

Kim³

et al. 2021

Preprint

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Background: We are to investigate prognostic factors of seizure after cardiopulmonary bypass surgery based on the incidence, the operation parameters, and the outcomes of seizure.Methods: Consecutive patients presented a seizure after a cardiac or aortic surgery using a cardiopulmonary bypass (CPB) during the admission between January 2006 and January 2019 were retrospectively enrolled. Patients with a previous seizure history were excluded. The medical records were reviewed on the demographics, associated medical conditions, laboratory, electroencephalography (EEG), and imaging findings, cardiopulmonary bypass parameters, types of seizure, and prognosis.Results: Among the 488 patients who received cardiopulmonary surgery using CPB, 29 patients were diagnosed with seizure during admission. There were nine cases of aortic valve replacement, six of mitral valve replacement, four of aorta graft, two of patent ductus arteriosus closure, coronary artery bypass graft, tricuspid annuloplasty, and tumor resection for each. The average durations of the operation and of cardiopulmonary bypass were 278±119 and 108±55 minutes, respectively. The average aortic cross clamping time was 72±41 minutes. The median detection time of a seizure was 34.38±83.37 hours after surgery. Twenty-three patients (79.3%) did not show recovery of mental status after surgery until the seizure was detected. Seventeen patients were diagnosed with status epilepticus, and two of them had nonconvulsive status epilepticus. Nine showed repetitive seizures and three presented a single seizure. EEG analysis showed five cases of spike-and-wave, four of periodic discharges, four of rhythmic delta, and one of burst suppression. From the image studies, sixteen patients showed stroke, two revealed posterior reversible encephalopathy syndrome, and two showed seizure related changes. Nine (31.0%) expired in 25±27 postoperative day. For the survived patients, the average duration of ICU admission was 9±7 days.Conclusions: Due to its difficulty of detecting preclinical seizure after the surgery, evaluation including performance of EEG in early postoperative phase should be considered.

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Section: Discussionmentioning

confidence: 55%