Postoperative Cognitive Dysfunction
Conditions
Keywords
cardiac, surgery, postoperative cognitive dysfunction, bypass, brain biomarkers, transcranial Doppler
Brief summary
The incidence of cognitive decline occurs in 53% of patients after cardiac surgery. Causes of POCD can be various: age, duration of cardiac bypass, medicaments and many others. The aim of this study is to determine factors causing postoperative cognitive dysfunction (POCD) and to identify which of them are most important
Detailed description
Prospective case-control study included patients undergoing cardiac at Clinic of Cardiac, Vascular and Thoracic Surgery, Lithuanian University of Health Sciences. Inclusion criteria is: 1) cardiac output \> 35%; 2) no agents affecting central nervous system; 3) no neuropathology; 5) no multiple organ dysfunction. Patients will have to perform mini mental state examination (MMSE), Trial making, addenbrooke tests before and 7 days after surgery. Brain biomarkers glial fibrillary acid protein (GFAP) and neurofilaments will be taken after induction, 24 and 48 hours after surgery. Transcranial Doppler will be performed to evaluate a.cerebri media blood flow speed during surgery. After these test, the investigators are going to examine data about patient and operation, recognize factors causing POCD and identify the most important of them.
Interventions
DIAGNOSTIC_TESTblood sample for brain biomarkers
Transcranial Doppler will be performed to evaluate a.cerebri media blood flow speed during surgery.
Sponsors
Rasa Bukauskiene
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Coronary artery bypass grafting or/and heart valve surgery; * Patients age\>18years * Cardiac output \>35%
Exclusion criteria
* Patient disagreement; * Diseases causing cognitive dysfunction; * Multi organic deficiency; * Agents affecting central nervous system
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Brain blood flow speed changes during surgery and correlation with POCD | 3 years | Transcranial Doppler will be performed to evaluate a.cerebri media blood flow speed during surgery using the 2MHz TCD ultrasound transducer over the temporal area. By adjusting the probe the curve of arteria will appear. Target measurement- mean flow velocity (MFV is measured in cm/s). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Brain biomarker GFAP concentration chances before and after surgery and correlation with POCD. | 3 years | Blood sample for brain biomarkers GFAP will be taken after induction, 24 and 48 hours after surgery. GFAP concentration in blood serum is measured in ng/ml |
| Brain biomarker neurofilaments concentration chances before and after surgery and correlation with POCD. | 3 years | Blood sample for brain biomarker neurofilaments will be taken after induction, 24 and 48 hours after surgery. GFAP concentration in blood serum is measured in pg/ml |
Other
| Measure | Time frame | Description |
|---|---|---|
| Determine factors causing POCD | 3 years | Patients will complete questionares: mini mental state examination (MMSE), Trial making and addenbrooke test one day before and 10 days after the surgery. We are going to compare change in tests results after surgery and find correlation with brain biomarkers and blood flow speed during surgery |
Countries
Lithuania
Contacts
Primary ContactRasa Bukauskiene
Backup ContactEdmundas Sirvinskas, Professor
Outcome results
None listed