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Effects of Balloon-Induced Pulsatile Perfusion on Postoperative Short- and Long-Term Cognitive Dysfunction in Diabetic Patients With Impaired Cerebrovascular Carbon Dioxide Reactivity.
MedLine Citation:
PMID:  23063103     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to identify whether reduced jugular venous oxygen saturation (SjvO(2)) in diabetic patients with impaired cerebrovascular carbon dioxide (CO(2)) reactivity could be improved by pulsatile perfusion during cardiopulmonary bypass (CPB) and whether improved SjvO(2) could improve postoperative cognitive dysfunction after coronary artery bypass graft surgery. SETTING: A prospective, observational study. PARTICIPANTS: Ninety-nine diabetic patients with impaired CO(2) reactivity (< 3%/mmHg). INTERVENTIONS: Ninety-nine diabetic patients divided into 2 groups: group 1 received an intra-aortic balloon pump (IABP) after the induction of anesthesia and group 2 did not. Group 1 received pulsatile perfusion during CPB, and group 2 received nonpulsatile perfusion during CPB. MEASUREMENTS AND MAIN RESULTS: Hemodynamic data (arterial and jugular venous gas values) were measured during CPB. All patients underwent neurologic and neuropsychologic tests the day before surgery and 7 days and 6 months after surgery. The duration of SjvO(2) ≤50% during CPB was shorter in group 1 (13 ± 5 minutes) than in group 2 (20 ± 6 minutes, p < 0.01). No significant differences in the rate of cognitive dysfunction were observed between groups at 7 days and 6 months postoperatively. CONCLUSIONS: Pulsatile perfusion flow generated by the IABP could reduce the decrease in SjvO(2) values during CPB, but amelioration of SjvO(2) values was not associated with short- or long-term postoperative cognitive dysfunction in diabetic patients with impaired CO(2) reactivity.
Authors:
Yuji Kadoi; Shigeru Saito; Nao Fujita; Akio Mizutani
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-9
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  -     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesiology, Gunma University Hospital, Gunma, Japan; Saitama Prefectural Cardiovascular Center, Saitama, Japan. Electronic address: kadoi@med.gunma-u.ac.jp.
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