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Neuroprotection During CPB: From Mechanisms to Interventions

Department of Anesthesia, University Hospital Campus-London Health Sciences Center, University of Western Ontario, London, Ontario, Canada; Department of Anesthesiology and Perioperative Medicine, University Hospital Campus-LHSC, 339 Windermere Rd., London, Ontario, Canada N6A 5A5

W. Douglas Boyd, MD, FRCPS

Department of Surgery, University Hospital Campus-London Health Sciences Center, University of Western Ontario, London, Ontario, Canada

Su Ganapathy, MD, FRCPC

Sandra J. Adams, RN

Rhonda C. Peterson, MA

Joanne Morgan, RN

Peter Lok, RRT

Department of Anesthesia, University Hospital Campus-London Health Sciences Center, University of Western Ontario, London, Ontario, Canada

The incidence and etiology of brain dysfunction after conventional coronary artery bypass surgery using cardiopulmonary bypass are reviewed. Stroke rates and incidences of cognitive dysfunction from various studies are considered. Mechanisms of injury including cerebral embolization as detected by transcranial Doppler and evidence for postoperative cerebral edema are discussed. Evidence for lower overall postoperative morbidity, and for a lower incidence of cognitive dysfunction specifically, after nonpump coronary revascularization is presented.

Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 6, No. 1, 3-6 (2002)
DOI: 10.1177/108925320200600103


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