Measures for reducing brain injury during cardiac surgery.
Brain injury is a major source of patient morbidity after cardiac surgery and is associated with prolonged hospitalization, excessive operative mortality, high hospital costs, and altered quality of life.
- cerebral embolism by air, fat, atheromatous debris, thrombus (micro- or macroemboli) 50% of strokes;
- hypoperfusion
- inflammatory processes evoked from CPB and/or ischemia/reperfusion injury;
Clinical forms of brain injury and relative frequencies:
| Clinical manifestation | Frequency |
|---|---|
| Stroke | |
| Low risk patient | ≤ 1% |
| High risk patient | 5% to 16% |
| Encephalopathy | 8.4% to 32% |
| Neurocognitive dysfunction | |
| Hospital discharge | 40% to 75% |
| One Month after surgery | 12% to 30% |
Recommendations for measures to protect brain injury during cardiac surgery:
