[Changes of cognitive function after open heart surgery with cardiopulmonary bypass: study of 50 cases].
OBJECTIVE
To investigate the effects of different factors associated with open heart surgery under cardiopulmonary bypass (CPB) on neurocognitive function.


METHODS
The cognitive capacity of 50 patients undergoing open heart surgery under CPB were studied on the day before operation and the 14th day postoperatively with Basic Cognitive Capacity Test battery, including 7 subtest: Digit Discrimination, Mental Arithmetic, Chinese Character Rotation, Digit Working Memory, Dual-word recognition, Tri-digit Recognition, and Meaningless Figure Recognition. The correlation between the postoperative cognitive decline and the factors associated with CPB was analyzed.


RESULTS
The total score of the Basic Cognitive Capacity Test 14 days postoperatively in 31 out of the 50 patients (62%) was 50 +/- 13, significantly lower than the preoperative score (54 +/- 10, P < 0.01), the decline being especially marked in Digit Discrimination, Digit Working Memory, and Dual-word Recognition (all P < 0.01). The postoperative decrease in cognitive function was correlated with age (P < 0.05), CPB time (P < 0.01), rewarming rate (P < 0.01), and the highest PaCO(2) (P < 0.05).


CONCLUSIONS
The incidence of cognitive dysfunction is higher in patients undergoing open heart surgery with CPB during the early postoperative period. Shortening CPB time, slowing rewarming, and appropriately increasing the level of PaCO2 will help to degrade the possibility of cognitive dysfunction after open heart surgery.
Qian
Yi-ning
YN
Department of Neurology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.
Zhang
Zhuo
Z
Meng
Xu
X
D000328:Adult; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications