MICROEMBOLI AND CEREBRAL IMPAIRMENT DURING CARDIAC-SURGERY

被引：94

作者：

PUGSLEY, W

KLINGER, L

PASCHALIS, C

ASPEY, B

NEWMAN, S

HARRISON, M

TREASURE, T

机构：

[1] Department of Cardiothoracic Surgery, Middlesex Hospital and University College, Middlesex Hospital Medical School, London

[2] Department of Psychology, Middlesex Hospital and University College, Middlesex Hospital Medical School, London

[3] Department of Neurology, Middlesex Hospital and University College, Middlesex Hospital Medical School, London

来源：

VASCULAR SURGERY | 1990年 / 24卷 / 01期

关键词：

D O I：

10.1177/153857449002400107

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Arterial microemboli, which may be reduced by arterial line filtration, have been proposed as a factor con tributing to cardiopulmonary bypass (CPB)-related cerebral dysfunction. The authors report on a study investi gating the effects of arterial line fil tration on the incidence of microemboli and the neuropsycho > 50mmHg, flow 1.8-2.4L/m2/min) was standardized and continuously monitored. Transcranial Doppler measured middle cerebral artery blood velocity and the incidence of microembolic events (MEE). Forty patients (median age fifty-six years, range forty-three to seventy) have completed the protocol. MEE oc curred in all patients during aortic cannulation and at inception of by pass. During bypass, patients with filtered CPB had fewer MEE (0-10 per thirty minutes) than nonfiltered CPB patients (30- > 250 per thirty minutes) did. Seven of 20 nonfiltered CPB patients showed soft neurologic signs on the first postoperative day compared with 3/20 in the filtered CPB group (P = 0.27, Fisher's). The filtered CPB patients performed bet ter on a verbal memory test (P < 0.01, Wilcoxon) at eight weeks than the nonfiltered CPB group did. © 1990, Sage Publications. All rights reserved.

引用

页码：34 / 43

页数：10

共 19 条

[1] Breuer A.C., Furlan A.J., Hanson M.R., Central nevous system complications of coronary artery bypass surgery. Prospective analysis of 421 patients, Stroke, 14, pp. 682-687, (1983)
[2] Kolkka R., Hilberman M., Neurological function following cardiac operation with low-flow, low-pressure cardiopulmonary bypass, J Thorac Cardiovasc Surg, 79, pp. 432-437, (1980)
[3] Shaw P.J., Bates D., Nef C., Early neurological complications of coronary artery bypass surgery, Br Med J, 291, pp. 1384-1387, (1985)
[4] Plc S., Treasure T., Newman S.P., Cerebral consequences of cardiopulmonary bypass, Lancet, i, pp. 823-825, (1986)
[5] Savageau J.A., Stanton B.A., Jenkins C.D., Neuropsychological function following elective cardiac operation. II. A six-month reassessment, J Thorac Cardiovasc Surg, 84, pp. 595-600, (1982)
[6] Taylor K.M., Pathophysiology of brain damage during open-heart surgery, Tex Heart Inst J, 13, pp. 91-96, (1986)
[7] Blauth C.I., Arnold J.V., Schulenberg W.E., Cerebral microembolism during cardiopulmonary bypass, J Thorac Cardiovasc Surg, 95, pp. 668-676, (1988)
[8] Aguilar M.J., Gerbode F., Hill J.D., Neuropathologic complications of cardiac surgery, J Thorac Cardiovasc Surg, 61, pp. 676-685, (1971)
[9] Pearson D.T., Carter R.F., Hammo M.B., Gaseous microemboli during open heart surgery, Techniques in Extracorporeal Circulation, (1981)
[10] Austen W.G., Howry D.H., Ultrasound as a method to detect bubbles or particulate matter in the arterial line during cardiopulmonary bypass, J Surg Res, 5, pp. 283-284, (1965)

← 1 2 →