Early postoperative cognitive dysfunction and blood pressure during coronary artery bypass graft operation

  • Gottesman R
  • Hillis A
  • Grega M
 et al. 
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Objective: To determine the relationship between change in blood pressure during coronary artery bypass graft operations and early cognitive dysfunction. Design: Cohort study. Setting: Quaternary care facility. Patients: Fifteen patients undergoing coronary artery bypass graft operations who were at high risk for postoperative stroke. Preoperative and intraoperative mean arterial pressures (MAPs) were measured in all patients. Intervention: A subset of patients underwent preoperative and postoperative magnetic resonance imaging. Main Outcome Measure: Change in cognitive performance, using the Mini-Mental State Examination and other simple cognitive tests. Results: A drop in MAP (preoperatively to intraoperatively) predicted a decrease in Mini-Mental State Examination score. When change in MAP was dichotomized (after excluding an outlier), subjects with a small decrease. improved on the Mini-Mental State Examination by 1 point, whereas those with a large drop in MAP worsened by 1.4 points (P=.04). Conclusion: A drop in MAP from a preoperative baseline may put patients at risk for early cognitive dysfunction after a coronary artery bypass graft operation.

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  • R F Gottesman

  • A E Hillis

  • M A Grega

  • L M Borowicz

  • O A Selnes

  • W A Baumgartner

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