Lack of Association Between Gaseous Microembolisms Assessed by a Single Detection Device and Cerebral Complications in Cardiac Surgery Patients
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Lack of Association Between Gaseous Microembolisms Assessed by a Single Detection Device and Cerebral Complications in Cardiac Surgery Patients. / Wiberg, Sebastian; Vedel, Anne Grønborg; Holmgaard, Frederik; Kjaergaard, Jesper; Langkilde, Annika R.; Hassager, Christian; Steensgaard, Jens; Rasmussen, Lars S.; Nilsson, Jens Christian.
I: Journal of Cardiothoracic and Vascular Anesthesia, Bind 34, Nr. 6, 06.2020, s. 1496-1503.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Lack of Association Between Gaseous Microembolisms Assessed by a Single Detection Device and Cerebral Complications in Cardiac Surgery Patients
AU - Wiberg, Sebastian
AU - Vedel, Anne Grønborg
AU - Holmgaard, Frederik
AU - Kjaergaard, Jesper
AU - Langkilde, Annika R.
AU - Hassager, Christian
AU - Steensgaard, Jens
AU - Rasmussen, Lars S.
AU - Nilsson, Jens Christian
PY - 2020/6
Y1 - 2020/6
N2 - Objective: To assess the association between total volume and number of gaseous microemboli (GME) in the cardiopulmonary bypass (CPB) circuit and the occurrence of new postoperative cerebral infarctions and postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery. Design: Predefined subanalyses of the randomized controlled Perfusion Pressure Cerebral Infarcts (PPCI) trial. Setting: Primary heart center in a university hospital. Participants: A total of 143 adult patients undergoing cardiac surgery with CPB. Interventions: Patients were allocated 1:1 to a low-target mean arterial pressure (MAP) of 40 to 50 mmHg or a high-target MAP of 70 to 80 mmHg during CPB with a fixed pump flow of 2.4 liters per minute per square meter body surface area plus 10% to 20%. Measurements and Main Results: The total volume and number of GME in the CPB circuit were assessed by the Bubble Counter Clinical 200® (GAMPT GmbH). New cerebral infarcts were identified by diffusion-weighted magnetic resonance imaging (DWI) 3 to 6 days after surgery. The median number of GME per patient was 8069 (range 1,523-204,095) with a median total volume of 1.2 μL (range 0.07-48 μL). A total of 66 (46%) patients had DWI detected cerebral infarcts postoperatively, and 36 (28%) patients had POCD after 7 days. The authors found no significant association between volume or number of GME with MAP target allocation, presence of cerebral infarction, or POCD. Conclusions: The authors found no significant associations between volume or number of GME with the occurrence of cerebral infarction or cognitive dysfunction in cardiac surgery patients.
AB - Objective: To assess the association between total volume and number of gaseous microemboli (GME) in the cardiopulmonary bypass (CPB) circuit and the occurrence of new postoperative cerebral infarctions and postoperative cognitive dysfunction (POCD) in patients undergoing cardiac surgery. Design: Predefined subanalyses of the randomized controlled Perfusion Pressure Cerebral Infarcts (PPCI) trial. Setting: Primary heart center in a university hospital. Participants: A total of 143 adult patients undergoing cardiac surgery with CPB. Interventions: Patients were allocated 1:1 to a low-target mean arterial pressure (MAP) of 40 to 50 mmHg or a high-target MAP of 70 to 80 mmHg during CPB with a fixed pump flow of 2.4 liters per minute per square meter body surface area plus 10% to 20%. Measurements and Main Results: The total volume and number of GME in the CPB circuit were assessed by the Bubble Counter Clinical 200® (GAMPT GmbH). New cerebral infarcts were identified by diffusion-weighted magnetic resonance imaging (DWI) 3 to 6 days after surgery. The median number of GME per patient was 8069 (range 1,523-204,095) with a median total volume of 1.2 μL (range 0.07-48 μL). A total of 66 (46%) patients had DWI detected cerebral infarcts postoperatively, and 36 (28%) patients had POCD after 7 days. The authors found no significant association between volume or number of GME with MAP target allocation, presence of cerebral infarction, or POCD. Conclusions: The authors found no significant associations between volume or number of GME with the occurrence of cerebral infarction or cognitive dysfunction in cardiac surgery patients.
KW - cardiopulmonary bypass
KW - cerebral infarction
KW - coronary artery bypass grafting
KW - gaseous microemboli
KW - postoperative cognitive dysfunction
U2 - 10.1053/j.jvca.2019.12.020
DO - 10.1053/j.jvca.2019.12.020
M3 - Journal article
C2 - 32035749
AN - SCOPUS:85079004296
VL - 34
SP - 1496
EP - 1503
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 6
ER -
ID: 242414036