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.

Main reasons:

  • 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 manifestationFrequency
Stroke
  Low risk patient≤ 1%
  High risk patient5% to 16%
Encephalopathy8.4% to 32%
Neurocognitive dysfunction
  Hospital discharge40% to 75%
  One Month after surgery12% to 30%



Recommendations for measures to protect brain injury during cardiac surgery:







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