Transcranial Doppler as a Predictor of Postoperative Cognitive Dysfunction Following Cardiopulmonary Bypass
Can Transcranial Doppler Predict Postoperative Cognitive Dysfunction After Cardiopulmonary Bypass
Bakirkoy Dr. Sadi Konuk Research and Training Hospital
106 participants
Apr 17, 2025
OBSERVATIONAL
Conditions
Summary
Neurological dysfunction either transient or permanent is a major cause of morbidity and mortality after cardiopulmonary bypass, and cognitive dysfunction is more frequent in cardiac surgery than in non-cardiac procedures. Variations in cerebral blood flow and oxygen extraction are considered key contributing factors. Although pulsatile flow during bypass has shown benefits for renal function and recovery, its effects on postoperative neurological dysfunction and delirium remain unclear due to limited research. This study aims to evaluate the impact of pulsatile versus non-pulsatile cardiopulmonary bypass flow on POCD in adult CABG patients by measuring middle cerebral artery (MCA) flow using transcranial Doppler.
Eligibility
Inclusion Criteria2
- Patients aged 18-70
- Patients scheduled for isolated elective cardiopulmonary bypass surgery
Exclusion Criteria8
- Patients with carotid stenosis ≥50%
- Emergency patients or those with a history of reoperation
- Patients with a history of cerebrovascular events
- Patients who do not provide consent
- Patients with temporal window failure
- Patients with an ejection fraction (EF) \<40%
- Patients with a Mini-Mental State Examination (MMSE) score \<23
- Patients who require mechanical ventilation for more than 24 hours or those who are reintubated
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Interventions
Transcranial Doppler examination was performed using a low-frequency (2-3.5 MHz) sector/cardiac probe through the transtemporal acoustic window. Middle cerebral artery (MCA) flow was identified in color Doppler mode at a depth of 3-7 cm with flow directed toward the probe. Pulsed-wave Doppler was applied, and peak systolic and end-diastolic velocities were recorded as the average of three measurements.
Locations(1)
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NCT07000461