Evaluation of coated oxygenators in cardiopulmonary-bypass systems and their impact on neurocognitive function.
BACKGROUND
Coronary artery bypass graft surgery (CABG) using cardiopulmonary bypass (CPB) is assumed to be associated with a decline of neurocognitive functions. This study was designed to analyse the neurocognitive function of patients with coronary heart disease before and after CABG and to determine possible protective effects of oxygenator surface coating on neurological outcome.


METHODS
Forty patients scheduled for selective CABG were prospectively randomized into two groups of 20 patients each according to the type of hollow-fibre membrane oxygenator used. Non-coated oxygenators (Group A) were compared to phosphorylcholine (PC)coated oxygenators (Group B). A battery of six neurological tests was administered preoperatively, 7-10 days and 4-6 months after surgery.


RESULTS
One patient of Group A suffered from a perioperative stroke and died on postoperative day 3, presumably because of sudden heart failure. Two patients of Group A (10%) developed a symptomatic transitory delirious psychotic syndrome (STPT) on postoperative days 3 and 5. None of the patients of Group B had perioperative complications. The test analysis revealed a trend of declined neurocognitive function early after CABG, but did not show any difference in neurocognitive outcome between the two groups.


CONCLUSIONS
PC coating of the oxygenators did not show any significant benefit on neurocognitive function after CABG using CPB.
Khosravi
Amir
A
Department of Cardiac Surgery, University of Rostock, Rostock, Germany.
Skrabal
Christian A
CA
Westphal
Bernd
B
Kundt
Guenther
G
Greim
Brigitte
B
Kunesch
Erwin
E
Liebold
Andreas
A
Steinhoff
Gustav
G
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible / Q000592:standards* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008606:Mental Processes; D008875:Middle Aged; D019965:Neurocognitive Disorders / Q000209:etiology / Q000517:prevention & control; D009483:Neuropsychological Tests; D010107:Oxygenators, Membrane / Q000009:adverse effects* / Q000592:standards; D010767:Phosphorylcholine / Q000627:therapeutic use; D020011:Protective Agents / Q000592:standards / Q000627:therapeutic use
D020099:Coated Materials, Biocompatible; D020011:Protective Agents; D010767:Phosphorylcholine