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Cognitive outcome after cardiac operations. Relationship to intraoperative computerized electroencephalographic data
C L Grote1, P T Shanahan, P Salmon
1Department of Psychology and Social Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1992
Summary
This study investigated if computerized electroencephalography (cEEG) could predict or limit neuropsychologic deficits after cardiopulmonary bypass. While careful attention to cerebral perfusion pressure showed promise, cEEG did not significantly improve patient outcomes.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Neurophysiology
Background:
- Cardiopulmonary bypass (CPB) is associated with new postoperative neuropsychologic deficits.
- Predicting and limiting these deficits is crucial for patient recovery.
Purpose of the Study:
- To assess if intraoperative computerized electroencephalography (cEEG) could predict or limit postoperative neuropsychologic deficits in patients undergoing CPB.
- To compare outcomes between patients whose cerebral perfusion pressure (CPP) was adjusted based on cEEG versus systemic pressure.
Main Methods:
- 29 patients undergoing CPB were monitored with on-line cEEG.
- 15 patients had CPP adjusted based on cEEG data; 14 patients had CPP monitored based on systemic pressure.
Main Results:
- New postoperative cognitive deficits were less prevalent than in previous studies in both groups.
- No significant difference in neuropsychologic outcomes was observed between the cEEG-guided and systemic pressure-guided CPP management groups.
- Intraoperative cEEG correlated with surgical outcomes but not with neuropsychologic outcomes.
Conclusions:
- Careful intraoperative management of cerebral perfusion pressure may reduce the incidence of postoperative neuropsychologic complications after CPB.
- The routine use of intraoperative computerized electroencephalography did not demonstrate a significant improvement in neuropsychologic outcomes in this study.