Dynamic cerebral autoregulation: A marker of post-operative delirium?

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art_CALDAS_Dynamic_cerebral_autoregulation_A_marker_of_postoperative_delirium_2019.PDF (296.08 KB)
Citações na Scopus
21
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER IRELAND LTD
Autores
PANERAI, Ronney B.
PASSOS, R. H.
Citação
CLINICAL NEUROPHYSIOLOGY, v.130, n.1, p.101-108, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective: We investigated the potential association of cerebral autoregulation (CA) with postoperative delirium (PD), a common complication of cardiac surgery with cardiopulmonary bypass (CPB). Methods: In patients undergoing coronary artery bypass graft (CABG) surgery with CPB, cerebral blood flow velocity (CBFV) and blood pressure (BP) were continuously recorded during 5-min preoperatively (T1), after 24 h (T2), and 7 days after procedure (T3). Prospective multivariate logistic regression analysis was performed to determine the independent risk factors of PD. Autoregulation index (ARI) was calculated from the CBFV response to a step change in BP derived by transfer function analysis. Results: In 67 patients, mean age 64.3 +/- 9.5 years, CA was depressed at T2 as shown by values of ARI (3.9 +/- 1.7), compared to T1 (5.6 +/- 1.7) and T3 (5.5 +/- 1.8) (p < 0.001). Impaired CA was found in 37 (55%) patients at T2 and in 7 patients (20%) at T3. Lower ARI at T1 and T2 were predictors of PD (p = 0.003). Conclusion: Dynamic CA was impaired after CABG surgery with CPB and was a significant independent risk factor of PD. Significance: Assessment of CA before and after surgery could have considerable potential for early identification of patients at risk of PD, thus reducing poor outcomes and length of stay.
Palavras-chave
Cardiac surgery, Cardiopulmonary bypass, Cerebral blood flow, Left ventricular ejection fraction
URI
https://observatorio.fm.usp.br/handle/OPI/30773
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCG
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
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