Brain protection in cardiac surgery.
Brain injury is a major source of patient morbidity after cardiac surgery, and is associated with prolonged hospitalization, excessive operative mortality, high hospital costs, and altered quality of life. Frequency and the clinical manifestations depend on multiple factors, including the completeness and timing of neurologic testing. Ischemic brain infarctions may or may not be associated with stroke or postoperative neurocognitive dysfunction, but the long-term implications of these lesions on neurologic function have not yet been extensively evaluated. This article reviews the current views on the pathophysiologic basis of cerebral injury after cardiac surgery and provides a summary of measures aimed at reducing its occurrence.
Grogan
Kelly
K
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Medical Institutions, The Johns Hopkins Hospital, 600 North Wolfe Street, Tower 711, Baltimore, MD 21287, USA.
Stearns
Joshua
J
Hogue
Charles W
CW