Neurocognitive Disorders
Conditions
Keywords
cardiovascular surgery, cerebral oxymetre, neurocognitive assessment
Brief summary
The aim of this study is to examine the effects of different but safe levels of arterial oxygen levels used in cardiac surgeries on cerebral oxygenation during the operation. It is also to investigate the effect on cognitive functions in the postoperative period. For our study the investigators will conduct a randomized control trial. Patients will be randomly assigned to one of two possible study groups according to the arterial oxygen levels.If there is any abnormality in cerebral oxygen levels during surgery, necessary intervention will be made by doctors.
Detailed description
In most cardiovascular surgeries, patients are frequently followed up at hyperoxemic level for safety purposes against the risk of tissue hypoxia that may develop during surgery due to CPB use. At the level of hyperoxemia, there are opinions that the ischemia-reperfusion damage increases with the follow-up of CABG surgery, microcirculation is impaired and tissue oxygenation is impaired due to the resulting hyperoxemic vasoconstriction. Recent research has focused on evaluating optimal oxygen levels in CPB during cardiac surgery. However, the potential of tightly regulated intraoperative normoxia to improve POCD following cardiac surgery has not been studied prospectively. The purpose of this study is to determine whether patients who underwent CPB and CABG, which were preserved under normoxic conditions during the intraoperative period, would have a lower incidence of early and late POCD than those exposed to hyperoxia.
Interventions
PROCEDUREprocedure: cerebral oxygenation intervention
During the surgery, cerebral oxygenation will be followed and intervention will be made to pH, PaO2, PaCO2, mean arterial pressure, hematocrit when necessary. In addition perfusion flow was maintained at or close to between 2.2-2.5 L/min/m2 . Perfusion pressure was adjusted using a phenylephrine infusion to maintain a mean arterial pressure of 50 to 70 mm Hg.
Sponsors
Bursa Yuksek Ihtisas Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* adult patients scheduled to undergo elective cardiopulmonary bypass graft surgery
Exclusion criteria
* severe preoperative cognitive impairment(i.e. dementia, intellectual disorder) * Non-Turkish speaking patients * presence of end-stage organ failure * patients requiring emergency coronary surgery * surgical procedures requiring single lung ventilation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| postoperative neurocognitive function | 12 hours after surgery | Change on MMSE is important for neurocognitive disorder.The MMSE consists of cognitive functions of orientation, attention, calculation, memory and language. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Extubation time after surgery | During the hospitalization for postoperative recovery ,average 8 days | Weaning times from mechanical ventilation among patients who are followed up with the same intensive care approach after surgery |
Countries
Turkey (Türkiye)
Outcome results
None listed