Cerebral Oximetry and Neurocognitive Functions in Cardiosurgical Patients
Cerebral Oximetry and Neurocognitive Functions in Cardiosurgical Patients
It is previously reported that the cerebral oxygen desaturation during cardiac surgery is
 associated with an increased incidence of cognitive impairment. The aim of this study is to
 determine whether intraoperative monitoring and predetermined interventions protocol to
 improve cerebral oxygenation during coronary artery bypass surgery provides benefits in
 neurocognitive functions.
Neurologic complications are major cause of morbidity following coronary artery bypass graft
 surgery.

 The neurologic injuries range in severity from subclinical cognitive changes to fatal brain
 injury and death. These complications represent a big impact on overall morbidity, and
 mortality in association with increased costs and length of hospital stay. The social impact
 is also very important with consequences on patients' quality of life. Several studies
 reported the incidence of cognitive decline after cardiac surgery that ranges from 30 to 80%.
 The most common etiologies are embolization and hypoperfusion of the brain.

 The In Vivo Optical Spectroscopy (INVOS) system uses near-infrared spectroscopy (NIRS) and
 provides noninvasive and continuous information on changes in regional oxygen saturation of
 blood in the brain (rSO2). When rSO2 decline occurs it can be responded with simple
 interventions to prevent a brain injury. These interventions include: repositioning of the
 head or perfusion cannulae, increasing arterial carbon dioxide tension, increasing oxygen
 inspiration concentration, increasing arterial blood pressure, adjusting pump flow rate,
 temperature decreasing, increasing of anesthetic depth and blood transfusion.

 Recent studies reported that intraoperative cerebral oxygen desaturation is associated with
 early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery.

 Neurocognitive function can be assessed with battery of standardized neurocognitive tests.
 Mini Mental State Examination, Color Trail Test, Grooved Pegboard Test are easy to perform
 bedside tests that test orientation, registration, attention, calculation, recall, language
 and complex visual-motor coordination.
Inclusion Criteria:

 -  All patients with coronary artery disease undergoing coronary artery bypass grafting
 (CABG) with cardiopulmonary bypass

 Exclusion Criteria:

 -  Who refuse to participate

 -  Previous stroke

 -  Preexisting psychiatric disease

 -  Significant carotid stenosis

 -  Ejection fraction below 25%

 -  Reoperations

 -  Emergent surgery

 -  Dialysis