Applied neuromonitoring and improving central nervous system outcomes.
This article will review the pathogenesis of perioperative neurological injury in patients undergoing coronary revascularization. The high percentage of such patients with diabetes or concomitant cerebrovascular disease renders this population particularly susceptible to injury as a consequence of both hypoperfusion and atheroemboli. The role of transesophageal echocardiography for assessment of ascending aortic atherosclerosis and the use of noninvasive cerebral oximetry to detect cerebral hypoperfusion are discussed with respect to their impact on patient outcomes.
Murkin
John M
JM
Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, Ontario, Canada. jmurkin@uwo.ca
D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D002490:Central Nervous System / Q000000981:diagnostic imaging / Q000293:injuries*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010092:Oximetry; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control*; D016896:Treatment Outcome