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[Cerebral arterial embolism during extracorporeal circulation].
Annales De L'Anesthesiologie Francaise
|January 1, 1977
Summary
Cerebral embolism during cardiopulmonary bypass (CPB) can cause neurological deficits. Early hyperbaric oxygen therapy is beneficial for treating these embolic events.
Area of Science:
- Neurology
- Cardiovascular Surgery
- Neurophysiology
Context:
- Observational study of 1,700 operations using cardiopulmonary bypass (CPB) from 1970-1975.
- Electroencephalography (EEG) and clinical data were collected to investigate cerebral embolism incidents during and after CPB.
- Identified 20 cases of cerebral embolism, with 18 occurring during CPB and 2 post-CPB.
Purpose:
- To analyze the incidence, characteristics, and clinical outcomes of cerebral embolism during cardiopulmonary bypass.
- To evaluate the diagnostic utility of electroencephalography (EEG) in detecting embolic events.
- To assess the effectiveness of hyperbaric oxygen therapy in managing post-CPB cerebral embolism.
Summary:
- A total of 20 cerebral embolism cases were documented: 9 air emboli, 4 atheromatous emboli, and 7 of probable gaseous origin.
- Initial diagnosis relied on EEG, with 10 cases showing minor and 10 moderate signs.
- Clinical symptoms, including delayed epilepsy, manifested later, with 4 cases experiencing severe outcomes (1 death, 3 permanent neurological deficits).
Impact:
- EEG is a crucial early indicator for detecting cerebral embolism during CPB.
- Delayed neurological symptoms, particularly epilepsy, are significant sequelae.
- Early hyperbaric oxygen therapy demonstrates a beneficial effect in managing cerebral embolic events post-CPB.