Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass.

Doganci, S; Gunaydin, S; Kocak, O Murat; Yilmaz, S; Demirkilic, U

BACKGROUND This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG). METHODS Over a 6-month period, GME activity was monitored in 102 Euroscore 6+ patients during cardiopulmonary bypass (CPB) with a conventional 32-micron arterial filter by non-invasive, real-time ultrasonic device. Cognitive tests; line bisection, the Stroop test, finger tapping, and the Rey Auditory Verbal Learning Test were performed at baseline, postoperative one week and postoperative one month. RESULTS The distribution of GME activity showed that there were three groups of patients: >500 total emboli (n = 38); 250 to 500 emboli (n = 30) and <250 emboli (n = 34) at a detection level of 2% of the circuit diameter on the arterial side. Line bisection, the Stroop test and finger tapping were impaired significantly in >500 emboli patients versus control (<250 emboli) in postoperative week one, but resolved in one month. CONCLUSIONS Correlation between intraoperative GME intensity and neurocognitive tests suggests that the level of GME might have a role in determining the psychological outcome after CABG with CPB.