Lack of Association Between Gaseous Microembolisms Assessed by a Single Detection Device and Cerebral Complications in Cardiac Surgery Patients
| Autor: | Anne G. Vedel, Frederik Holmgaard, Lars S. Rasmussen, Jesper Kjaergaard, Jens Steensgaard, Jens-Christian Nilsson, Christian Hassager, Sebastian Wiberg, Anne Langkilde |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Mean arterial pressure 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law Internal medicine medicine Cardiopulmonary bypass Embolism Air Humans Arterial Pressure Cardiac Surgical Procedures Body surface area Cardiopulmonary Bypass medicine.diagnostic_test Cerebral infarction business.industry Magnetic resonance imaging Cerebral Infarction medicine.disease Cardiac surgery Anesthesiology and Pain Medicine Cardiology Gases Cardiology and Cardiovascular Medicine business Postoperative cognitive dysfunction Perfusion |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 34(6) |
| ISSN: | 1532-8422 |
| Popis: | Objective To assess the association between total volume and number of gaseous microemboli (GME) in the cardiopulmonary bypass (CPB) circuit and the occurrence of new postoperative cerebral infarctions and postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery. Design Predefined subanalyses of the randomized controlled Perfusion Pressure Cerebral Infarcts (PPCI) trial. Setting Primary heart center in a university hospital. Participants A total of 143 adult patients undergoing cardiac surgery with CPB. Interventions Patients were allocated 1:1 to a low-target mean arterial pressure (MAP) of 40 to 50 mmHg or a high-target MAP of 70 to 80 mmHg during CPB with a fixed pump flow of 2.4 liters per minute per square meter body surface area plus 10% to 20%. Measurements and Main Results The total volume and number of GME in the CPB circuit were assessed by the Bubble Counter Clinical 200® (GAMPT GmbH). New cerebral infarcts were identified by diffusion-weighted magnetic resonance imaging (DWI) 3 to 6 days after surgery. The median number of GME per patient was 8069 (range 1,523-204,095) with a median total volume of 1.2 μL (range 0.07-48 μL). A total of 66 (46%) patients had DWI detected cerebral infarcts postoperatively, and 36 (28%) patients had POCD after 7 days. The authors found no significant association between volume or number of GME with MAP target allocation, presence of cerebral infarction, or POCD. Conclusions The authors found no significant associations between volume or number of GME with the occurrence of cerebral infarction or cognitive dysfunction in cardiac surgery patients. |
| Databáze: | OpenAIRE |
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