Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania.
Department of Disaster Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.
Medicina (Kaunas). 2024 Aug 17;60(8):1337. doi: 10.3390/medicina60081337.
: Cardiac surgery is associated with various durations of cerebral autoregulation (CA) impairment and can significantly impact cognitive function. Cognitive functions such as memory, psychomotor speed, and attention are significantly impacted after cardiac surgery, necessitating prioritization of these areas in cognitive function tests. There is a lack of research connecting cerebral autoregulation impairment to specific cognitive function domains after cardiac surgery. This study aimed to determine if impaired cerebral autoregulation is associated with postoperative memory impairment and to test the hypothesis that the duration of this impairment affects the development of postoperative memory issues. : A prospective study was conducted in 2021-2023. After approval of the Ethics Committee and with patient's written consent, 83 adult patients undergoing elective on-pump coronary artery bypass graft (CABG) surgery were enrolled. All patients were assessed for cognitive function 1 day before surgery using the Mini-Mental state examination (MMSE-2) test as a screening tool and the Hopkins Verbal Learning Test-Revised (HVLT-R) to assess memory specifically. To diagnose possible memory impairment (IM), all patients underwent a repeat assessment of cognitive function on the 7th-10th postoperative day. Cerebral autoregulation monitoring using transcranial Doppler was performed. Cerebral autoregulation status index (Mx) was recorded using Intensive Care Brain Monitoring System software, 9.1.5.23 (Cambridge, UK). : According to our research, the incidence of postoperative memory impairment is 30.1%. Temporary cerebral autoregulation impairment occurs in all patients undergoing elective in-pump CABG surgery. The duration of the single longest CA impairment event in seconds (LCAI) and the LCAI dose were higher in patients with postoperative memory impairment, = 0.006 and < 0.007, respectively. Cerebral autoregulation impairment is important in developing memory loss after cardiac surgery. The duration and dose of the LCAI event are predictive of postoperative memory impairment.
心脏手术与多种脑自动调节(CA)受损持续时间相关,并可能显著影响认知功能。心脏手术后,记忆、心理运动速度和注意力等认知功能会受到显著影响,因此需要在认知功能测试中优先考虑这些领域。目前缺乏研究将 CA 受损与心脏手术后特定的认知功能领域联系起来。本研究旨在确定 CA 受损是否与术后记忆障碍有关,并检验假设,即这种受损的持续时间会影响术后记忆问题的发展。
这是一项在 2021 年至 2023 年进行的前瞻性研究。在伦理委员会批准并获得患者书面同意后,共纳入 83 名接受择期体外循环冠状动脉旁路移植术(CABG)的成年患者。所有患者均在术前 1 天使用简易精神状态检查(MMSE-2)作为筛查工具,使用霍普金斯言语学习测试修订版(HVLT-R)专门评估记忆来评估认知功能。为了诊断可能存在的记忆障碍(IM),所有患者在术后第 7-10 天进行重复认知功能评估。使用经颅多普勒监测脑自动调节。使用 Intensive Care Brain Monitoring System 软件(剑桥,英国)9.1.5.23 记录脑自动调节状态指数(Mx)。
根据我们的研究,术后记忆障碍的发生率为 30.1%。所有接受择期体外 CABG 手术的患者均出现短暂的 CA 受损。术后记忆障碍患者的最长单次 CA 受损事件持续时间(LCAI)秒数和 LCAI 剂量较高,分别为 = 0.006 和 < 0.007。脑自动调节受损是心脏手术后发生记忆丧失的重要因素。LCAI 事件的持续时间和剂量可预测术后记忆障碍。