Centrifugal versus roller head pumps for cardiopulmonary bypass: Effect on early neuropsychologic outcomes after coronary artery surgery

Scott, David A.; Silbert, Brendan; Doyle, Timothy J.; Blyth, Carolyn; Borton, Mary C.; O’Brien, Jennifer L.; Horne, David

doi:10.1053/jcan.2002.128413

Cited by 30 publications

(28 citation statements)

References 37 publications

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“…Visual analog scales are especially suitable for this situation because they offer simple, reliable, and valid techniques while placing minimal demands on subjects. 17,18 Subjects were asked to mark an ungraded line (10 cm in length) anchored by "least" and "most" at each end.…”

Section: Assessment Of Subjectsmentioning

confidence: 99%

Preexisting Cognitive Impairment and Mild Cognitive Impairment in Subjects Presenting for Total Hip Joint Replacement

et al. 2011

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Background The prevalence of preexisting cognitive impairment (PreCI) is documented before cardiac surgery, but there is less information before noncardiac surgery. In addition, the prevalence of mild cognitive impairment, defined by different cognitive criteria and subjective complaints, and which may progress to Alzheimer disease, is unknown in these subjects. Because anesthesia and surgery have been implicated in Alzheimer disease pathology, we prospectively measured PreCI and mild cognitive impairment in subjects scheduled for total hip joint replacement surgery in an observational study. Methods One hundred fifty-two subjects 60 y of age and older who were scheduled for total hip joint replacement surgery underwent assessment, including neuropsychologic testing, 1 week before surgery. Test results were compared with published norms. PreCI was defined as impairment in two or more of seven cognitive tests, for which impairment in an individual test was defined as ≥ 2 SD below norms for that test. Amnestic mild cognitive impairment (aMCI) was defined as impairment ≥1.5 SD below norms for results of the immediate and/or delayed Auditory Verbal Learning Test plus a subjective complaint. Results Subjects performed worse compared with normative data on five of seven neuropsychologic tests. Thirty (20% [95% CI, 13-26%]) subjects were classified as having PreCI. Thirty-four (22% [95% CI, 16-29%]) were classified as having aMCI. Ten (7%) subjects were classified as having both PreCI and aMCI, representing 33% of the 30 subjects with PreCI. Conclusions The prevalence of aMCI in subjects scheduled for total hip joint replacement surgery is similar to that in the general community. PreCI and aMCI tend to identify different subjects. Because aMCI is known to progress to Alzheimer disease, future studies that track cognition before and after anesthesia and surgery should document the presence or absence of aMCI so that the rate of conversion to Alzheimer disease after anesthesia and surgery can be compared with the rate in the nonsurgical population.

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Section: Assessment Of Subjectsmentioning

confidence: 99%

Preexisting Cognitive Impairment and Mild Cognitive Impairment in Subjects Presenting for Total Hip Joint Replacement

et al. 2011

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“…The alternative method uses centrifugation and results in improved neurological outcome 26 but with a nonsignificant decrease in POCD incidence. 27 Perhaps the most frequently described mechanism of brain injury in CABG surgery is based on the recognition that microemboli are generated by the surgeon manipulating the heart and aorta, through cardiotomy suctioning, and by the cardiopulmonary bypass circuit itself. Microemboli can be detected intraoperatively as high-intensity transient signals by transcranial Doppler sonography.…”

Section: Hogan Et Al Fixing Hearts and Protecting Minds 163mentioning

confidence: 99%

Fixing Hearts and Protecting Minds

et al. 2013

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“…30 Scott identified more neurobehavioral test deficits among the roller pump group, however this difference did not reach statistical significance. 34 A study of 3438 consecutive patients revealed that the use of the centrifugal pump showed a trend toward risk reduction for adverse neurological events. 31 Randomized trials with neurological measures as a primary outcome variable, however, have not demonstrated significant differences in neurobehavioral outcomes or tissuelevel markers of brain injury (S100 beta) between types of CPB pumps.…”

Section: Groom Et Al Detection and Elimination Of Cpb Emboli 195mentioning

confidence: 99%

“…31 Randomized trials with neurological measures as a primary outcome variable, however, have not demonstrated significant differences in neurobehavioral outcomes or tissuelevel markers of brain injury (S100 beta) between types of CPB pumps. 34,35 In the largest randomized trial, Klein and colleagues assigned 1000 adult cardiac patients to management with a roller pump or a centrifugal pump, with reductions in blood loss, renal function, and neurological outcome demonstrated in the centrifugal group. 32 Neurological injuries, predominantly embolic in origin, are unwanted sequellae of CABG surgery.…”

Section: Groom Et Al Detection and Elimination Of Cpb Emboli 195mentioning

confidence: 99%

Detection and Elimination of Microemboli Related to Cardiopulmonary Bypass

Groom

Quinn²,

Lennon³

et al. 2009

Circ: Cardiovascular Quality and Outcomes

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Background-Neurobehavioral impairment is a common complication of coronary bypass surgery. Cerebral microemboli during cardiopulmonary bypass (CPB) are a principal mechanism of cognitive injury. The aim of this work was to study the occurrence of cerebral embolism during CPB and to evaluate the effectiveness of evidence-based CPB circuit component and process changes on the exposure of the patient to emboli. Methods and Results-M-Mode

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Centrifugal versus roller head pumps for cardiopulmonary bypass: Effect on early neuropsychologic outcomes after coronary artery surgery

Cited by 30 publications

References 37 publications

Preexisting Cognitive Impairment and Mild Cognitive Impairment in Subjects Presenting for Total Hip Joint Replacement

Preexisting Cognitive Impairment and Mild Cognitive Impairment in Subjects Presenting for Total Hip Joint Replacement

Fixing Hearts and Protecting Minds

Detection and Elimination of Microemboli Related to Cardiopulmonary Bypass

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