Microemboli are not associated with delirium after coronary artery bypass graft surgery

被引:26
作者
Rudolph, James L. [1 ,8 ]
Babikian, Viken L. [2 ,9 ]
Treanor, Patrick [3 ]
Pochay, Val E. [2 ]
Wigginton, Jeremy B. [4 ]
Crittenden, Michael D. [3 ,5 ]
Marcantonio, Edward R. [6 ,7 ]
机构
[1] Boston VA Healthcare Syst, GRECC, Boston, MA 02130 USA
[2] Boston VA Healthcare Syst, Dept Neurol, Boston, MA 02130 USA
[3] Boston VA Healthcare Syst, Div Cardiac Surg, Boston, MA 02130 USA
[4] Univ Mississippi, Med Ctr, Jackson, MS 39216 USA
[5] St Louis VA Med Ctr, Dept Surg, St Louis, MO USA
[6] Beth Israel Deaconess Med Ctr, Div Gerontol, Boston, MA 02215 USA
[7] Beth Israel Deaconess Med Ctr, Div Gen Med & Primary Care, Boston, MA 02215 USA
[8] Brigham & Womens Hosp, Div Aging, Boston, MA 02115 USA
[9] Boston Univ, Sch Med, Dept Neurol, Boston, MA 02118 USA
来源
PERFUSION-UK | 2009年 / 24卷 / 06期
关键词
microembolism; aged; delirium; coronary artery bypass graft; carotid stenosis; transcranial doppler; CONFUSION ASSESSMENT METHOD; CARDIOPULMONARY BYPASS; POSTOPERATIVE DELIRIUM; CEREBRAL MICROEMBOLI; CARDIAC OPERATIONS; COGNITIVE CHANGE; PREDICTION RULE; CONSENSUS; SIGNALS; EMBOLI;
D O I
10.1177/0267659109358207
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Delirium is an acute change in cognition which occurs frequently after coronary artery bypass graft (CABG) surgery. Cerebral microemboli, from plaque, air, or thrombus, have been hypothesized to contribute to delirium and cognitive decline after CABG. The purpose of this study was to determine if there was an association between cerebral microemboli and delirium after cardiac surgery. Non-delirious patients (n=68) were prospectively enrolled and underwent intraoperative monitoring of the middle cerebral arteries with transcranial Doppler (TCD). TCD signals were saved and analyzed postoperatively for microemboli manually, according to established criteria. Postoperatively, patients were assessed for delirium with a standardized battery. Thirty-three patients (48.5%) developed delirium after surgery. Microemboli counts (mean +/- SD) were not significantly different in those with and without delirium (303 +/- 449 vs. 299 +/- 350; p= 0.97). While intraoperative microemboli were not associated with delirium after CABG, further investigation into the source and composition of microemboli can further elucidate the long-term clinical impact of microemboli.
引用
收藏
页码:409 / 415
页数:7
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