Cerebral injury during cardiopulmonary bypass: Emboli impair memory

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Presentation transcript:

Cerebral injury during cardiopulmonary bypass: Emboli impair memory S.J. Fearn, PhD, FRCS, R. Pole, BSc, K. Wesnes, PhD, E.B. Faragher, PhD, FSS, T.L. Hooper, MD, FRCS, C.N. McCollum, MD, FRCS The Journal of Thoracic and Cardiovascular Surgery Volume 121, Issue 6, Pages 1150-1160 (June 2001) DOI: 10.1067/mtc.2001.114099 Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Preoperative cerebrovascular reactivity, for both cerebral hemispheres, for all patients undergoing CABG. Each point represents the cerebrovascular reactivity for an individual. The plot demonstrates that over 80% of patients undergoing CABG have impaired cerebrovascular reserve (<0.86). Lines depict median and IQR. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 1150-1160DOI: (10.1067/mtc.2001.114099) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 MAP and MCA flow velocity are plotted for all CABG patients before and during bypass. Each point represents an individual. Despite a significant fall in MAP, MCA flow velocity increased during bypass, suggesting increased arterial tone (*P <.0001, Wilcoxon). Lines depict median and IQR. Rt, right; Lt, left. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 1150-1160DOI: (10.1067/mtc.2001.114099) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Regional CsO2 is plotted for all patients undergoing CABG. Each point represents an individual. CsO2 fell significantly during cooling and bypass, suggesting increased oxygen extraction (*P <.0001, Wilcoxon). Lines depict median and IQR. Rt, right; Lt, left. The Journal of Thoracic and Cardiovascular Surgery 2001 121, 1150-1160DOI: (10.1067/mtc.2001.114099) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Cerebrovascular reactivity is plotted against accuracy of number vigilance 1 week postoperatively for all patients undergoing CABG. Each point represents an individual. Patients with poor cerebrovascular reactivity were found to perform poorly in this test of attention (r = 0.34, P =.01, Spearman). The Journal of Thoracic and Cardiovascular Surgery 2001 121, 1150-1160DOI: (10.1067/mtc.2001.114099) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 The number of emboli detected in the left MCA by TCD was plotted against the change in accuracy of memory 1 week postoperatively for all patients undergoing CABG. Each point represents an individual. Memory was impaired by high embolic counts (r = 0.4, P =.001, Spearman). The Journal of Thoracic and Cardiovascular Surgery 2001 121, 1150-1160DOI: (10.1067/mtc.2001.114099) Copyright © 2001 American Association for Thoracic Surgery Terms and Conditions