title: Raised jugular venous pressure intensifies release of brain injury biomarkers in patients undergoing cardiac surgery.
abstract: OBJECTIVE
  Neurologic damage after cardiac surgery with extracorporeal circulation is multifactorial. Despite several studies, its pathophysiology is poorly understood. The purpose of this study was to determine the changes in jugular venous pressure and to analyze their effect on perioperative brain injury measured by biomarkers in patients undergoing coronary artery bypass grafting.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Department of cardiac surgery in a medical university hospital.
  
  
  METHODS
  Adult patients undergoing elective coronary artery bypass grafting with extracorporeal circulation under general anesthesia.
  
  
  METHODS
  The right jugular vein was cannulated in retrograde fashion. Jugular venous pressure was measured in the jugular vein bulb (JVBP). Concentrations of plasma glial fibrillary acidic protein, tau protein, arteriovenous lactate, and jugular vein saturation were measured as the markers of brain injury during the surgery and early postoperative period. All were analyzed in relation to JVBP.
  
  
  RESULTS
  Increased JVBP was noted after extracorporeal circulation and after surgery. A significant increase >12 mmHg for JVBP, increased plasma glial fibrillary acidic protein, tau protein, arteriovenous lactate concentrations, and decreased jugular vein saturation were observed.
  
  
  CONCLUSIONS
  Cardiac surgery increased JVBP and an increased JVBP > 12 mmHg intensified an increase in brain injury biomarker concentrations.
authors.affiliation: Department of Anesthesiology Intensive Therapy, Medical University of Lublin, Lublin, Poland. w.dabrowski5@yahoo.com
authors.forename: Wojciech
authors.initials: W
authors.lastname: Dabrowski
authors.forename: Edyta
authors.initials: E
authors.lastname: Kotlinska
authors.forename: Ziemowit
authors.initials: Z
authors.lastname: Rzecki
authors.forename: Marek
authors.initials: M
authors.lastname: Czajkowski
authors.forename: Adam
authors.initials: A
authors.lastname: Stadnik
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Olszewski
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001930:Brain Injuries / Q000209:etiology / Q000503:physiopathology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005112:Extracorporeal Circulation / Q000009:adverse effects; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006801:Humans; D007601:Jugular Veins / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*; D014690:Venous Pressure / Q000502:physiology*; D016875:tau Proteins / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D016875:tau Proteins