Differential Age Effects of Mean Arterial Pressure and Rewarming on Cognitive Dysfunction After Cardiac Surgery
| Autor: | L. R. Smith, David C. Kramer, Elizabeth A. Towner, Joseph G. Reves, Narda D. Croughwell, I. Sanderson, William D. White, Mark F. Newman, James A. Blumenthal |
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| Rok vydání: | 1995 |
| Předmět: |
Male
Aging medicine.medical_specialty Mean arterial pressure Population Blood Pressure Neuropsychological Tests Body Temperature law.invention Cognition Hypothermia Induced Memory law Cardiopulmonary bypass medicine Humans Cardiac Surgical Procedures Rewarming Cognitive decline education Aged education.field_of_study Cardiopulmonary Bypass Multivariable linear regression business.industry Middle Aged Cardiac surgery Anesthesiology and Pain Medicine Blood pressure Anesthesia Multivariate Analysis Linear Models Female Hypotension Cognition Disorders business |
| Zdroj: | Anesthesia & Analgesia. 81:236-242 |
| ISSN: | 0003-2999 |
| DOI: | 10.1097/00000539-199508000-00005 |
| Popis: | Central nervous system dysfunction is a common consequence of otherwise uncomplicated cardiac surgery. Many mechanisms have been postulated for the cognitive dysfunction that is part of these neurologic sequelae. The purpose of our investigation was to evaluate the effects of mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) and the rate of rewarming on cognitive decline after cardiac surgery. Two hundred thirty-seven patients completed preoperative and predischarge neuropsychologic testing. MAP and temperature were recorded at 1-min intervals using an automated anesthesia record keeper. MAP area less than 50 mm Hg (time and degree of hypotension), as well as the maximal rewarming rate, were determined for each patient. Multivariable linear regression revealed that the rate of rewarming and MAP were unrelated to cognitive decline. However, interactions significantly associated with cognitive decline were found between age and MAP area less than 50 mm Hg on one measure, and between age and rewarming rate in another, identifying susceptibility of the elderly to these factors. Although MAP and rewarming were not the primary determinates of cognitive decline in this surgical population, hypotension and rapid rewarming contributed significantly to cognitive dysfunction in the elderly. |
| Databáze: | OpenAIRE |
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