Journal of Cardiothoracic and Vascular Anesthesia
Volume 23, Issue 1 , Pages 14-21 , February 2009

Neurocognitive Function in Patients Undergoing Coronary Artery Bypass Graft Surgery With Cardiopulmonary Bypass: The Effect of Two Different Rewarming Strategies

  • Bikash Sahu, MD, DNB, PDCC

      Affiliations

    • Department of Cardiac Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
    • Corresponding Author InformationAddress reprint requests to Bikash Sahu, MD, DNB, PDCC, Department of Cardiac Anesthesia, CN Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
    • ,
  • Sandeep Chauhan, MD, PDCC

      Affiliations

    • Department of Cardiac Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
    • ,
  • Usha Kiran, MD

      Affiliations

    • Department of Cardiac Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
    • ,
  • Akshay Bisoi, MCh

      Affiliations

    • Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India
    • ,
  • Ramakrishnan Lakshmy, MD

      Affiliations

    • Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
    • ,
  • Thiruvenkadam Selvaraj, MD, DNB, MNAMS

      Affiliations

    • Department of Cardiac Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
    • ,
  • Ashima Nehra, PhD

      Affiliations

    • Department of Clinical Psychology, All India Institute of Medical Sciences, New Delhi, India

References 

  1. Grocott HP, Mackensen GB, Grigore AM, et al. Postoperative hyperthermia is associated with cognitive dysfunction after coronary artery bypass graft surgery. Stroke. 2002;33:537–541
  2. Mclean RF, Wong MD, Naylor CD, et al. Cardiopulmonary bypass, temperature and central nervous system dysfunction. Circulation. 1994;90:II-250-II-55
  3. Croughwell ND, Frasco P, Blumenthal JA, et al. Warming during cardiopulmonary bypass is associated with jugular bulb desaturation. Ann Thorac Surg. 1992;53:827–832
  4. Nakajima T, Kuro M, Hayashi Y, et al. Clinical evaluation of cerebral oxygen balance during cardiopulmonary bypass: Online continuous monitoring of jugular venous oxygen saturation. Anesth Analg. 1992;74:630–635
  5. Westaby S, Andrew JP, Blomquist S, et al. Serum s100β protein: A potential marker for cerebral events during CPB. Ann Thorac Surg. 1996;6:88–92
  6. Fletcher JM, Levin HS, Satz P. Neuropsychological and intellectual assessment in children. In:  Kaplan HI,  Sadock BI editor. Comprehensive Textbook of Psychiatry. (ed 5). Baltimore, MD: Williams and Wilkins; 1989;p. 513–525
  7. Kohli A, Manreet K, Manju M, et al. Neuropsychological functioning in specific learning disorders—Reading, writing and mixed groups. J Indian Assoc Child Adolesc Ment Health. 2006;2:112–115
  8. Clark JA, Bar-Yosef S, Anderson A, et al. Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2005;19:426–429
  9. Cook DJ, Orszulak TA, Daly RC, et al. Cerebral hyperthermia during cardiopulmonary bypass in adults. J Thorac Cardiovasc Surg. 1996;111:268–269
  10. Stone JG, Young WL, Smith CR, et al. Do standard monitoring sites reflect the true brain temperature when profound hypothermia is rapidly induced and reversed?. Anesthesiology. 1995;82:344–351
  11. Arrowsmith JE, Grocott HP, Reves JG, et al. Central nervous system complications of cardiac surgery. Br J Anaesth. 2000;84:378–393
  12. Cheng WP, Marino MR, Romanogli A, et al. Temperature measurement during CPB. Anesthesiology. 2000;93:A384
  13. Nussmeier NA, Li S, Strickler AG, et al. Temperature measurement during CPB. Anesth Analg. 2002;93:SCA35
  14. Grocott HP, Newman MF, Croughwell NA, et al. Continuous jugular venous versus nasopharyngeal temperature monitoring during hypothermic CPB for cardiac surgery. J Clin Anesth. 1997;9:312–316
  15. Busto R, Dietrich W, Globus MT, et al. The importance of brain temperature in cerebral ischemic injury. Stroke. 1989;20:1113–1114
  16. Dietrich WD, Busto R, Valdes I, et al. Effect of normothermic vs mild hypothermic forebrain ischemia in rats. Stroke. 1990;21:1318–1325
  17. Reith J, Jorgensen H, Pedersen P, et al. Body temperature in acute stroke: Relation to stroke severity, infarct size, mortality and outcome. Lancet. 1996;347:422–425
  18. Sternau L, Globus MT, Dietrich W. Ischemia-induced neurotransmitter release: effects of mild intraischemic hyperthermia. In:  Globus MT,  Dietrich W editor. The Role of Neurotransmitter in Brain Injury. New York, NY: Plenum Press; 1992;p. 33–38
  19. Globus M, Busto R, Lin B, et al. Detection of free radical activity during transient global ischemia and recirculation: Effects of intraischemic brain temperature modulation. J Neurochem. 1995;65:1250–1256
  20. Dietrich W, Halley M, Valdes I, et al. Interrelationship between increased vascular permeability and acute neuronal damage following temperature-controlled brain ischemia in rats. Acta Neuropathol. 1991;81:615–625
  21. Chopp M, Welch KM, Tidwell CD, et al. Effect of mild hyperthermia on recovery of metabolic function after global cerebral ischemia in rats. Stroke. 1998;19:1521–1525
  22. Grigore AM, Grocott HP, Mathew JP, et al. The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery. Anesth Analg. 2002;94:4–10
  23. Mora CT, Henson MB, Weintraub WS, et al. Effect of temperature management during cardiopulmonary bypass on neurologic and neuropsychological outcome in patients undergoing coronary revascularisation. J Thorac Cardiovasc Surg. 1996;112:514–522
  24. Nathan JH, Wells GA, Munson JL, et al. Neuroprotective effects of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass. Circulation. 2001;104(suppl I):I-85–I-91
  25. Nathan HJ, Rodriguez R, Wozny D, et al. Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass: Five-year follow-up of a randomized trial. J Thorac Cardiovasc Surg. 2007;133:1206–1211
  26. Boodhwani M, Rubens F, Wozny D, et al. Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery: A randomized, double- blind study. J Thorac Cardiovasc Surg. 2007;134:1443–1452
  27. Plourde G, Leduc AS, Morin JE, et al. Temperature during cardiopulmonary bypass for coronary artery operations does not influence postoperative cognitive function: A prospective, randomized trial. J Thorac Cardiovasc Surg. 1997;114:123–128
  28. Engelman RM, Pleet AB, Rousou JA, et al. Influence of cardiopulmonary bypass perfusion temperature on neurologic and hematologic function after coronary artery bypass grafting. Ann Thorac Surg. 1999;67:1547–1556
  29. Chen CS, Len BK, Liu K. Detection of cerebral desaturation during CPB by cerebral oximetry. Acta Anaesthesiol Sin. 1996;34:173–178
  30. Van Knobelsdorff G, Tonner PH, Havel F, et al. Prolonged rewarming after hypothermic cardiopulmonary bypass does not attenuate reduction of jugular bulb oxygen saturation. J Cardiothorac Vasc Anesth. 1997;11:689–693
  31. Von Knobelsdorff G, Hanel F, Werner C, et al. Jugular bulb oxygen saturation and middle cerebral blood flow velocity during cardiopulmonary bypass. J Neurosurg Anesthesiol. 1997;9:128–133
  32. Van der Linden J, Ekroth R, Linole C, et al. Is cerebral blood flow metabolic mismatch during rewarming a risk factor after profound hypothermic procedure in small children?. Eur J Cardiothorac Surg. 1989;3:209–215
  33. Croughwell N, Smith LR, Quill T, et al. The effect of temperature on cerebral metabolism and blood flow in adults during cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1992;103:549–554
  34. Croughwell ND, Newman MF, Blumenthal JA, et al. Jugular bulb saturation and cognitive dysfunction after cardiopulmonary bypass. Ann Thorac Surg. 1994;58:1702–1708
  35. Jonsson H, Blomquist S, Westaby S, et al. Significance of serum s100β release after coronary artery bypass grafting. Ann Thorac Surg. 1998;65:1639–1644
  36. Shaaban MA, Harmer M, Vaughan R. Serum s100 protein as a marker of cerebral damage during cardiac surgery. Br J Anaesth. 2000;85:287–298
  37. Fazio V, Bhudia SK, Maricha N, et al. Peripheral detection of s100β during cardiothoracic surgery: What are we really measuring?. Ann Thorac Surg. 2004;78:46–53

PII: S1053-0770(08)00222-X

doi: 10.1053/j.jvca.2008.07.010

Journal of Cardiothoracic and Vascular Anesthesia
Volume 23, Issue 1 , Pages 14-21 , February 2009

Article Tools