Postoperative cognitive dysfunction following cardiac surgery

Abstract

Postoperative cognitive dysfunction following cardiac surgeryKazuyuki Nagata 1) ，Kosuke Nakajima 1) ，Arudo Hiraoka 3) ，Masahisa Arimichi 1) ，Tomoya Oshita 1) ，Ryosuke Muraki 1) ， Yoshitaka Naito 2) ，Manami Himeno 2) ，Taichi Sakaguchi 3) Abstract ［Background］ Various causes of postoperative cognitive dysfunction (POCD) following cardiac surgery have been speculated, including a previous report that found use of a heart-lung machine to be a causative factor. ［Methods］ We investigated 160 consecutive patients who underwent a heart valve operation with a cardiopulmonary bypass, and received 4 different types of pre-and postoperative recognition function tests. Those who showed a greater than 20％ reduction in postoperative test values or experienced difficulty with the assessments following surgery were judged to be POCD. Factors related to POCD occurrence were then evaluated using multivariate analysis. ［Results］ POCD occurred in 49 cases (30.6％) . Comparisons between the onset and non-onset groups revealed that patients with onset were significantly older, while many of those had a medical history of cognitive impairment and blood symptoms, as well as higher HbA1c values. The onset group also had a significantly shorter rewarming time during cardiopulmonary bypass, and significantly lower perfusion index (PI) , hemoglobin, and oxygen delivery (DO2i) values during re-［原稿受領日：2019 年 1 月 15 日 採択日：2019 年 3 月 1 日］ 永田和之 1) ・中島康佑 1) ・平岡有努 3) ・有道真久 1) ・大下智也 1) 村木亮介 1) ・内藤善隆 2) ・姫野麻菜美 2) ・坂口太一 3) 人工心肺を用いた心臓手術における術後高次脳機能障害の検討 1)心臓病センター榊原病院 臨床工学科 永田和之