TY - JOUR
T1 - Microemboli are not associated with delirium after coronary artery bypass graft surgery
AU - Rudolph, James L.
AU - Babikian, Viken L.
AU - Treanor, Patrick
AU - Pochay, Val E.
AU - Wigginton, Jeremy B.
AU - Crittenden, Michael D.
AU - Marcantonio, Edward R.
PY - 2009/11
Y1 - 2009/11
N2 - Delirium is an acute change in cognition which occurs frequently after coronary artery bypass graft (CABG) surgery. Cerebral microemboli, from plaque, air, or thrombus, have been hypothesized to contribute to delirium and cognitive decline after CABG. The purpose of this study was to determine if there was an association between cerebral microemboli and delirium after cardiac surgery. Non-delirious patients (n=68) were prospectively enrolled and underwent intraoperative monitoring of the middle cerebral arteries with transcranial Doppler (TCD). TCD signals were saved and analyzed postoperatively for microemboli manually, according to established criteria. Postoperatively, patients were assessed for delirium with a standardized battery. Thirty-three patients (48.5%) developed delirium after surgery. Microemboli counts (mean ± SD) were not significantly different in those with and without delirium (303 ± 449 vs. 299 ± 350; p=0.97). While intraoperative microemboli were not associated with delirium after CABG, further investigation into the source and composition of microemboli can further elucidate the long-term clinical impact of microemboli.
AB - Delirium is an acute change in cognition which occurs frequently after coronary artery bypass graft (CABG) surgery. Cerebral microemboli, from plaque, air, or thrombus, have been hypothesized to contribute to delirium and cognitive decline after CABG. The purpose of this study was to determine if there was an association between cerebral microemboli and delirium after cardiac surgery. Non-delirious patients (n=68) were prospectively enrolled and underwent intraoperative monitoring of the middle cerebral arteries with transcranial Doppler (TCD). TCD signals were saved and analyzed postoperatively for microemboli manually, according to established criteria. Postoperatively, patients were assessed for delirium with a standardized battery. Thirty-three patients (48.5%) developed delirium after surgery. Microemboli counts (mean ± SD) were not significantly different in those with and without delirium (303 ± 449 vs. 299 ± 350; p=0.97). While intraoperative microemboli were not associated with delirium after CABG, further investigation into the source and composition of microemboli can further elucidate the long-term clinical impact of microemboli.
KW - Aged
KW - Carotid stenosis
KW - Coronary artery bypass graft
KW - Delirium
KW - Microembolism
KW - Transcranial doppler
UR - http://www.scopus.com/inward/record.url?scp=76149118423&partnerID=8YFLogxK
U2 - 10.1177/0267659109358207
DO - 10.1177/0267659109358207
M3 - Article
C2 - 20093336
AN - SCOPUS:76149118423
SN - 0267-6591
VL - 24
SP - 409
EP - 415
JO - Perfusion
JF - Perfusion
IS - 6
ER -