Effect of the type of cardiopulmonary bypass pump flow on postoperative cognitive function in patients undergoing isolated coronary artery surgery
1Dr. Siyami Ersek Cardiothoracic and Vascular Surgery Education and Research Hospital, Department of Cardiovascular Surgery, İstanbul-Turkey
218 Mart Univesity, Faculty of Medicine, Department of Cardiovascular Surgery, Çanakkale-Turkey
3Pamukkale Univesity, Faculty of Medicine, Department of Cardiovascular Surgery, Denizli-Turkey
4Göztepe Education and Research Hospital, Department of Anesthesiology, İstanbul-Turkey
Anatol J Cardiol 2016; 11(16): 875-880 PubMed ID: 27163534 PMCID: 5324892 DOI: 10.14744/AnatolJCardiol.2015.6572
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Abstract

Objective: Pulsatile flow, generated by a pump during cardiopulmonary bypass, has been accepted as more physiological in coronary artery bypass grafting surgery (CABG). Therefore, we aimed to investigate the effects of pulsatile and nonpulsatile flow on postoperative cognitive function and to review relationship with the biomarkers S100β and neuron-specific enolase (NSE).
Materials and Methods: Patients who underwent isolated CABG were included this prospective, randomized, double-blind study, which was performed be- tween March 2010 and December 2010. Patients were divided into two groups: pulsatile (Group I, n=20) and nonpulsatile (Group II, n=20) flow. Blood samples were collected 1 day before surgery and in the sixth postoperative hour for the analysis of S100β and NSE. In addition, Mini- Mental State Examination (MMSE) was performed during preoperative period and on third postoperative day. Outcomes were determination of effects of pump flow type on cognitive function and relationships with concentrations of S100β and NSE.
Results: Forty patients were included. No differences were observed between the groups with respect to complications, mortality, S100β (Group I: 1.9±0.2 μ/L; Group II: 2.0±0.2 μ/L), NSE (Group I: 12.5±0.8 μ/L; Group II: 12.4±0.7 μ/L), MMSE scores [Group I: 25 (23–27); Group II: 25 (23–27)], and postoperative cognitive dysfunction (POCD) (p>0.05). No correlation was observed between MMSE scores and concentrations of S100β (r=–0.032) and NSE (r=–0.423) (p>0.05).
Conclusion: There was no difference between types of pump flow for POCD and no relationship between cognitive dysfunction and S100β and NSE concentrations. Pump flow type does not affect NSE concentrations. (Anatol J Cardiol 2016; 16: 875-80)