Neurocognitive outcomes after cardiac surgery

Karsten Bartels, David L. Mcdonagh, Mark F. Newman, Joseph P. Mathew

Research output: Contribution to journalReview article

28 Scopus citations

Abstract

PURPOSE OF REVIEW: To summarize recent studies of neurocognitive dysfunction after cardiac surgery, as well as to outline efforts and approaches toward advancing the field. RECENT FINDINGS: Observational studies have improved our understanding of the incidence and the trajectory of cognitive decline after cardiac surgery; however, the magnitude of this neurocognitive change remains controversial because of the inconsistent definitions and the lack of a gold-standard diagnostic modality. Nonetheless, physicians commonly see patients with functional and cognitive impairments after cardiac surgery, which utilize healthcare resources and impact quality of life. Novel approaches have utilized advanced neuroimaging techniques as well as innovative monitoring modalities to improve the efficiency of neuroprotective strategies during cardiac surgery. SUMMARY: Adverse cognitive and neurologic outcomes following cardiac surgery range from discrete neurocognitive deficits to severe neurologic injury such as stroke and even death. The elderly are at higher risk of suffering these outcomes and the public health dimension of this problem is expected to accelerate. Future studies should combine advanced neuroimaging with genomic, transcriptional, proteomic, and metabolomic profiling to improve our understanding of the pathophysiologic mechanisms and optimize the diagnosis, prevention, and treatment of neurocognitive injury.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalCurrent Opinion in Anaesthesiology
Volume26
Issue number1
DOIs
StatePublished - Feb 1 2013

Keywords

  • Cardiac surgery
  • Cognition
  • Outcomes
  • Perioperative

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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