title: Impact of the intensity of microemboli on neurocognitive outcome following cardiopulmonary bypass.
abstract: BACKGROUND
  This study aimed to determine whether there was any association between the intensity of intraoperative gaseous microembolic signals (GME), neuropsychological testing and clinical outcome in high-risk patients undergoing coronary artery surgery (CABG).
  
  
  METHODS
  Over a 6-month period, GME activity was monitored in 102 Euroscore 6+ patients during cardiopulmonary bypass (CPB) with a conventional 32-micron arterial filter by non-invasive, real-time ultrasonic device. Cognitive tests; line bisection, the Stroop test, finger tapping, and the Rey Auditory Verbal Learning Test were performed at baseline, postoperative one week and postoperative one month.
  
  
  RESULTS
  The distribution of GME activity showed that there were three groups of patients: >500 total emboli (n = 38); 250 to 500 emboli (n = 30) and <250 emboli (n = 34) at a detection level of 2% of the circuit diameter on the arterial side. Line bisection, the Stroop test and finger tapping were impaired significantly in >500 emboli patients versus control (<250 emboli) in postoperative week one, but resolved in one month.
  
  
  CONCLUSIONS
  Correlation between intraoperative GME intensity and neurocognitive tests suggests that the level of GME might have a role in determining the psychological outcome after CABG with CPB.
authors: Gulhane Military Academy of Medicine, Department of Cardiovascular Surgery, Ankara, Turkey.
authors: S
authors: S
authors: Doganci
authors: S
authors: S
authors: Gunaydin
authors: O Murat
authors: OM
authors: Kocak
authors: S
authors: S
authors: Yilmaz
authors: U
authors: U
authors: Demirkilic
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D003071:Cognition; D057505:Embolic Protection Devices; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged