Prevention of neurologic complications of cardiac surgery
- Michael L McGarvey, MD
Michael L McGarvey, MD
- Associate Professor of Neurology
- University of Pennsylvania School of Medicine
- Albert T Cheung, MD
Albert T Cheung, MD
- Professor of Anesthesia
- Stanford University School of Medicine
- Mark M Stecker, MD, PhD
Mark M Stecker, MD, PhD
- Chairman of Neuroscience
- Winthrop University Hospital
- Section Editors
- Gabriel S Aldea, MD
Gabriel S Aldea, MD
- Section Editor — Cardiac Surgery
- Professor of Surgery
- University of Washington
- Michael J Aminoff, MD, DSc
Michael J Aminoff, MD, DSc
- Editor-in-Chief — Neurology
- Section Editor — Medical Neurology
- Professor of Neurology
- University of California, San Francisco School of Medicine
- Jonathan B Mark, MD
Jonathan B Mark, MD
- Section Editor — Cardiac Anesthesia
- Professor of Anesthesiology
- Duke University Medical Center
- Chief, Anesthesiology Service
- Veterans Affairs Medical Center
Neurologic complications are second only to heart failure as a cause of morbidity and mortality following cardiac surgery, and the presence of neurologic sequelae significantly increases the likelihood of requiring long-term care.
Most neurologic problems following cardiac surgery can be divided into three categories (table 1):
●Neuropsychiatric abnormalities or encephalopathy
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- REDUCING NEUROLOGIC COMPLICATIONS
- Preoperative evaluation
- Atrial fibrillation
- Minimally invasive surgery
- Cardiopulmonary bypass
- - Bypass temperature
- - Acid-base status
- - Blood pressure
- Patient positioning
- Intraoperative monitoring
- - TEE
- - EEG
- - Other
- Pharmacologic neuroprotection
- - Statins
- - Barbiturates
- - Erythropoietin