Neuropsychological Testing: Methodology, Interpretation and OutcomesCerebral Blood Flow Laboratories, Wake Forest University School of Medicine, Winston-Salem, NC; Department of Anesthesia, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1009 The outcome most dreaded by patient and surgeon alike is a brain dysfunction. Numerous surveys indicate most patients would prefer death to significant neurological impairment. Cardiac surgery currently enjoys a remarkable safety record in regard to a low death rate and major cerebral infarctions. However, neurobehavioral dysfunction, i.e. memory, coordination, and attention deficits, continues to be an area that is identified in the literature as a major negative outcome associated with cardiac surgery. If the cardiac surgical community is going to eliminate brain injury associated with interoperative methods and apparatus, then a sensitive, reproducible and quick assessment of brain function that can be reliably correlated with surgical interventions is a basic requirement. This paper discusses the experimental design, environmental and statistical concerns relative to selecting a battery of neurobehavioral assessment tools appropriate for cardiac surgery patients so, as a team, we can make a safe operation safer.
Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 6, No. 1,
27-33 (2002) |
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