Brain damage and neurological outcome after open-heart surgery.

Sotaniemi, K. A.

doi:10.1136/jnnp.43.2.127

Cited by 116 publications

(30 citation statements)

References 31 publications

(6 reference statements)

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“…Retrograde cerebral perfusion during cardiac operations may potentially protect the patients from embolic strokes (48). In the present study, a similar prevalence of neurological disorders following cardiac operations to what have been reported in the literature was presented (49). Moreover, the biomarkers appeared earlier and lasted longer in the CSF than in the serum.…”

Section: Discussionsupporting

confidence: 71%

Biomarkers of cerebral injury in cardiac surgery

Yuan¹

2014

Anadolu Kardiyol Derg

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The present study aims to reveal the changing patterns of cerebral biomarkers and the underlying predictive factors as a consequence of cardiac surgery. Literature retrieval of articles on S100 and S100B of recent 20 years were made in the MEDLINE database, Highwire Press and Google search. Quantitative data of S100 and S100B along with neuron-specific enolase were carefully screened, collected and statistically analyzed. The biomarkers appeared earlier and lasted longer in the cerebrospinal fluid than in the serum. All three biomarkers exhibited a similar kinetic trend in the bloodstream, reaching a peak value at the end of cardiopulmonary bypass (CPB). In adults, serum biomarkers may recover to normal earlier than in pediatrics undergoing a cardiac surgery. The patients undergoing off-pump surgery had the minimal elevations of cerebral biomarkers comparing to all other cardiac surgeries under CPB, low core temperature and/or hypothermic circulatory arrest. In patients with pre-or postoperative neurological disorders, the biomarkers in the serum elevated even before operation and persisted longer time than those without neurological disorders. The serum concentrations of the biomarkers showed direct correlation with CPB duration and core temperature. Cardiac operations may lead to cerebral damage and blood-brain barrier changes, as a consequence of CPB and low core temperature. The cerebral biomarkers including S100, S100B and neuron-specific enolase may precisely reflect the cerebral damages in cardiac surgery. Attention has to be paid to the attenuations of cerebral damage by modifying the surgical conditions of CPB and core temperature.

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Section: Discussionsupporting

confidence: 71%

Biomarkers of cerebral injury in cardiac surgery

Yuan¹

2014

Anadolu Kardiyol Derg

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“…Activation of the complement system with disruption of cell membranes may occur as a result of CPB. , [6][7][8][9][10][11][12][13][14][15][16][17][18][19] In a group of dogs undergoing hypothermic CPB, Johnston et al , 4 found that cerebral blood flow (CBF) was markedly reduced during 150 min of hypothermic CPB and remained so even after rewarming. They saw a small, but significant, rise in intracranial pressure (ICP) but could demonstrate no evidence of brain oedema on the basis of cerebral water content.…”

Section: Discussionmentioning

confidence: 99%

Does hypothermia or hyperventilation affect enflurane MAC reduction following partial cardiopulmonary bypass in dogs?

Doak

Hall

et al. 1993

Can J Anaesth

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This study in dogs determined the effect of systemic cooling and arterial hypocarbia during cardiopulmonary bypass (CPB) on the requirements for enflurane anaesthesia (MAC) before and after CPB. Twelve mongrel dogs were each anaesthetized with enflurane in oxygen on (MAC 3 and MAC 4). Dogs were randomly assigned according to PaC02 management during CPB (low, 17.6 5: 8.6 mmHg vs high, 38.9 + 11.5 mmHg) (has,17,6 + 8,6 mmHg vs haut, 38,9 • 11,5 mmHg)

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“…6,7 Soon it became clear that central neurological complications of heart surgery were not limited to intracardiac (open heart) surgery but were seen in extracardiac (coronary artery bypass surgery) as well. 8 The precise prevalence of cognitive decline after coronary artery bypass grafting varies widely, presumably depending on the sensitivity of the neuropsychological tests used, but have been found by some to be much more prevalent than the roughly 8% found in the present study by Jensen et al 1 Newman and colleagues, 9 who defined a significant decline as a 20% reduction from baseline, found a cognitive decline in 53% of patients at discharge, 36% at 6 weeks, 24% at 6 months, and 42% at 5 years.…”

Section: Article P 2790mentioning

confidence: 99%

Can Cognition Survive Heart Surgery?

Samuels

2006

Circulation

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Brain damage and neurological outcome after open-heart surgery.

Cited by 116 publications

References 31 publications

Biomarkers of cerebral injury in cardiac surgery

Biomarkers of cerebral injury in cardiac surgery

Does hypothermia or hyperventilation affect enflurane MAC reduction following partial cardiopulmonary bypass in dogs?

Can Cognition Survive Heart Surgery?

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