Early postoperative cognitive dysfunction and blood pressure during coronary artery bypass graft operation.
OBJECTIVE
To determine the relationship between change in blood pressure during coronary artery bypass graft operations and early cognitive dysfunction.


METHODS
Cohort study.


METHODS
Quaternary care facility. Patients Fifteen patients undergoing coronary artery bypass graft operations who were at high risk for postoperative stroke. Preoperative and intraoperative mean arterial pressures (MAPs) were measured in all patients. Intervention A subset of patients underwent preoperative and postoperative magnetic resonance imaging. Main Outcome Measure Change in cognitive performance, using the Mini-Mental State Examination and other simple cognitive tests.


RESULTS
A drop in MAP (preoperatively to intraoperatively) predicted a decrease in Mini-Mental State Examination score. When change in MAP was dichotomized (after excluding an outlier), subjects with a small decrease improved on the Mini-Mental State Examination by 1 point, whereas those with a large drop in MAP worsened by 1.4 points (P = .04).


CONCLUSIONS
A drop in MAP from a preoperative baseline may put patients at risk for early cognitive dysfunction after a coronary artery bypass graft operation.
Gottesman
Rebecca F
RF
Department of Neurology, Johns Hopkins University School of Medicine, Phipps 126, 600 N Wolfe St, Baltimore, MD 21287, USA. rgottesm@jhmi.edu
Hillis
Argye E
AE
Grega
Maura A
MA
Borowicz
Louis M
LM
Selnes
Ola A
OA
Baumgartner
William A
WA
McKhann
Guy M
GM
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001921:Brain / Q000473:pathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D011300:Preoperative Care; D011581:Psychological Tests; D012307:Risk Factors