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[Brain protection in heart surgery].

M Iacoboni1, V Di Piero, A Auteri

  • 1Dipartimento di Scienze neurologiche, Università La Sapienza, Roma.

Recenti Progressi in Medicina
|November 1, 1991
PubMed
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Citicoline (CDP-choline) did not prevent cognitive decline after open-heart surgery. Both high and low doses showed persistent neuropsychological deficits and hypoperfusion, indicating limited brain protection during extra-corporeal circulation.

Area of Science:

  • Neurology
  • Neuroscience
  • Cardiovascular Surgery

Background:

  • Open-heart surgery often involves extra-corporeal circulation (ECC), posing risks to brain function.
  • Cognitive deficits post-ECC can impact patient recovery and quality of life.

Purpose of the Study:

  • To investigate the neuroprotective effects of citicoline (CDP-choline) in patients undergoing open-heart surgery with ECC.
  • To evaluate the impact of different CDP-choline dosages on neurological, neuropsychological, and cerebral blood flow (CBF) outcomes.

Main Methods:

  • A randomized study of 40 patients undergoing open-heart surgery.
  • Two treatment groups: Group A received high-dose CDP-choline, Group B received low-dose CDP-choline, both initiated pre-surgery and continued post-surgery.
  • Evaluations included neurological exams, neuropsychological tests, CT scans, and CBF measurements at multiple time points (pre-op, 2 weeks, 1 month, 6 months post-op).

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Main Results:

  • No significant difference in neurological symptoms or morphostructural lesions between groups post-surgery.
  • Both groups showed significant neuropsychological deficits at 2 weeks post-surgery, with persistent deficits observed at 6 months in 66% (Group A) and 86% (Group B) of affected patients.
  • CBF data revealed hypoperfusion areas in 9 patients in Group A and 10 patients in Group B at 2 weeks post-surgery.

Conclusions:

  • CDP-choline, at the tested dosages, did not demonstrate significant neuroprotective effects against cognitive decline following open-heart surgery with ECC.
  • Both high and low doses of CDP-choline were associated with persistent neuropsychological deficits and cerebral hypoperfusion post-operatively.
  • Further research may be needed to explore alternative or adjunctive strategies for brain protection during ECC.