Intraoperative cerebral high-intensity transient signals and postoperative cognitive function: a systematic review

American Journal of Surgery

Volumn 197, Issue 1, 2009, Pages 55-63

  Martin, Kristin K ^a,b   Wigginton, Jeremy B ^c   Babikian, Viken L ^d,e   Pochay, Val E ^d   Crittenden, Michael D ^d   Rudolph, James L ^d,f  

^a General Surgery Residency   (United States)

^b UNIVERSITY OF NORTH TEXAS   (United States)

^c UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE   (United States)

^d VA BOSTON HEALTHCARE SYSTEM   (United States)

^e BOSTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^f HARVARD MEDICAL SCHOOL   (United States)

Author keywords

Cardiac surgery; Carotid endarterectomy; Embolism; Orthopedic surgery; Postoperative cognitive dysfunction; Surgery; Transcranial Doppler

Indexed keywords

CAROTID ENDARTERECTOMY; COGNITION; COGNITIVE DEFECT; CORONARY ARTERY BYPASS SURGERY; DOPPLER ECHOGRAPHY; HEART SURGERY; HUMAN; ORTHOPEDIC SURGERY; POSTOPERATIVE CARE; PRIORITY JOURNAL; REVIEW; SCORING SYSTEM; SYSTEMATIC REVIEW;

CARDIAC SURGICAL PROCEDURES; COGNITION DISORDERS; ENDARTERECTOMY, CAROTID; HUMANS; INTRACRANIAL EMBOLISM; INTRAOPERATIVE CARE; ORTHOPEDIC PROCEDURES; ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL;

EID: 57749178849     PISSN: 00029610     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.amjsurg.2007.12.060     Document Type: Review

References (66)

1. Newman M.F., Kirchner J.L., Phillips-Bute B., et al. Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med 344 (2001) 395-402
2. van Dijk D., Jansen E.W., Hijman R., et al. Cognitive outcome after off-pump and on-pump coronary artery bypass graft surgery: a randomized trial. JAMA 287 (2002) 1405-1412
3. Russell D. Cerebral microemboli and cognitive impairment. J Neurol Sci (2002) 203-204 :211-4
4. Borger M.A., Peniston C.M., Weisel R.D., et al. Neuropsychologic impairment after coronary bypass surgery: effect of gaseous microemboli during perfusionist interventions. J Thorac Cardiovasc Surg 121 (2001) 743-749
5. Blauth C.I. Macroemboli and microemboli during cardiopulmonary bypass. Ann Thorac Surg 59 (1995) 1300-1303
6. Newman S.P., and Harrison M.J. Coronary-artery bypass surgery and the brain: persisting concerns. Lancet Neurol 1 (2002) 119-125
7. Aly A., Babikian V.L., Barest G., et al. Brain microembolism. J Neuroimaging 13 (2003) 140-146
8. Khuri S.F., Henderson W.G., DePalma R.G., et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 242 (2005) 326-343
9. Stygall J., Newman S.P., Fitzgerald G., et al. Cognitive change 5 years after coronary artery bypass surgery. Health Psychol 22 (2003) 579-586
10. Diegeler A., Hirsch R., Schneider F., et al. Neuromonitoring and neurocognitive outcome in off-pump versus conventional coronary bypass operation. Ann Thorac Surg 69 (2000) 1162-1166
11. Bowles B.J., Lee J.D., Dang C.R., et al. Coronary artery bypass performed without the use of cardiopulmonary bypass is associated with reduced cerebral microemboli and improved clinical results. Chest 119 (2001) 25-30
12. Wang D., Wu X., Li J., et al. The effect of lidocaine on early postoperative cognitive dysfunction after coronary artery bypass surgery. Anesth Analg 95 (2002) 1134-1141
13. Motallebzadeh R., Bland J.M., Markus H.S., et al. Neurocognitive function and cerebral emboli: randomized study of on-pump versus off-pump coronary artery bypass surgery. Ann Thorac Surg 83 (2007) 475-482
14. Whitaker D.C., Newman S.P., Stygall J., et al. The effect of leucocyte-depleting arterial line filters on cerebral microemboli and neuropsychological outcome following coronary artery bypass surgery. Eur J Cardiothorac Surg 25 (2004) 267-274
15. Whitaker D., Stygall J., Harrison M., et al. Relationship between white cell count, neuropsychologic outcome, and microemboli in 161 patients undergoing coronary artery bypass surgery. J Thorac Cardiovasc Surg 131 (2006) 1358-1363
16. Hammon Jr. J.W., Stump D.A., Kon N.D., et al. Risk factors and solutions for the development of neurobehavioral changes after coronary artery bypass grafting. Ann Thorac Surg 63 (1997) 1613-1618
17. Gaunt M.E., Martin P.J., Smith J.L., et al. Clinical relevance of intraoperative embolization detected by transcranial Doppler ultrasonography during carotid endarterectomy: a prospective study of 100 patients. Br J Surg 81 (1994) 1435-1439
18. Spencer M.P. Transcranial Doppler monitoring and causes of stroke from carotid endarterectomy. Stroke 28 (1997) 685-691
19. Ackerstaff R.G., Moons K.G., van de Vlasakker C.J., et al. Association of intraoperative transcranial doppler monitoring variables with stroke from carotid endarterectomy. Stroke 31 (2000) 1817-1823
20. Muller M., Reiche W., Langenscheidt P., et al. Ischemia after carotid endarterectomy: comparison between transcranial Doppler sonography and diffusion-weighted MR imaging. AJNR Am J Neuroradiol 21 (2000) 47-54
21. Heyer E.J., Sharma R., Rampersad A., et al. A controlled prospective study of neuropsychological dysfunction following carotid endarterectomy. Arch Neurol 59 (2002) 217-222
22. Heyer E.J., Adams D.C., Solomon R.A., et al. Neuropsychometric changes in patients after carotid endarterectomy. Stroke 29 (1998) 1110-1115
23. Babikian V.L., and Cantelmo N.L. Cerebrovascular monitoring during carotid endarterectomy. Stroke 31 (2000) 1799-1801
24. Stork J.L., Levi C.R., Chambers B.R., et al. Possible determinants of early microembolism after carotid endarterectomy. Stroke 33 (2002) 2082-2085
25. Crawley F., Stygall J., Lunn S., et al. Comparison of microembolism detected by transcranial Doppler and neuropsychological sequelae of carotid surgery and percutaneous transluminal angioplasty. Stroke 31 (2000) 1329-1334
26. Patterson B.M., Healey J.H., Cornell C.N., et al. Cardiac arrest during hip arthroplasty with a cemented long-stem component. A report of seven cases. J Bone Joint Surg Am 73 (1991) 271-277
27. Colonna D.M., Kilgus D., Brown W., et al. Acute brain fat embolization occurring after total hip arthroplasty in the absence of a patent foramen ovale. Anesthesiology 96 (2002) 1027-1029
28. Yeon H.B., Ramappa A., Landzberg M.J., et al. Paradoxic cerebral embolism after cemented knee arthroplasty: a report of 2 cases and prophylactic option for subsequent arthroplasty. J Arthroplasty 18 (2003) 113-120
29. Weiss S.J., Cheung A.T., Stecker M.M., et al. Fatal paradoxical cerebral embolization during bilateral knee arthroplasty. Anesthesiology 84 (1996) 721-723
30. Sulek C.A., Davies L.K., Enneking F.K., et al. Cerebral microembolism diagnosed by transcranial Doppler during total knee arthroplasty: correlation with transesophageal echocardiography. Anesthesiology 91 (1999) 672-676
31. Pell A.C., Christie J., Keating J.F., et al. The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. A study of 24 patients with femoral and tibial fractures. J Bone Joint Surg Br 75 (1993) 921-925
32. Christie J., Burnett R., Potts H.R., et al. Echocardiography of transatrial embolism during cemented and uncemented hemiarthroplasty of the hip. J Bone Joint Surg Br 76 (1994) 409-412
33. Rodriguez R.A., Letts M., Jarvis J., et al. Cerebral microembolization during pediatric scoliosis surgery: a transcranial doppler study. J Pediatr Orthop 21 (2001) 532-536
34. Droste D.W., Kuhne K., Schaefer R.M., et al. Detection of microemboli in the subclavian vein of patients undergoing haemodialysis and haemodiafiltration using pulsed Doppler ultrasound. Nephrol Dial Transplant 17 (2002) 462-466
35. Moller J.T., Cluitmans P., Rasmussen L.S., et al. Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet 351 (1998) 857-861
36. Rodriguez R.A., Tellier A., Grabowski J., et al. Cognitive dysfunction after total knee arthroplasty: effects of intraoperative cerebral embolization and postoperative complications. J Arthroplasty 20 (2005) 763-771
37. Koch S., Forteza A., Lavernia C., et al. Cerebral fat microembolism and cognitive decline after hip and knee replacement. Stroke 38 (2007) 1079-1081
38. Abraham P., Carter D., Millot J.R., et al. Prolonged asymptomatic micro-embolism after hip or knee arthroplasty. J Bone Joint Surg Br 79 (1997) 269-272
39. Ringelstein E.B., Droste D.W., Babikian V.L., et al. Consensus on microembolus detection by TCD. International Consensus Group on Microembolus Detection. Stroke 29 (1998) 725-729
40. Russell D., and Brucher R. Online automatic discrimination between solid and gaseous cerebral microemboli with the first multifrequency transcranial Doppler. Stroke 33 (2002) 1975-1980
41. Brucher R., and Russell D. Automatic online embolus detection and artifact rejection with the first multifrequency transcranial Doppler. Stroke 33 (2002) 1969-1974
42. Abu-Omar Y., Cader S., Guerrieri Wolf L., et al. Short-term changes in cerebral activity in on-pump and off-pump cardiac surgery defined by functional magnetic resonance imaging and their relationship to microembolization. J Thorac Cardiovasc Surg 132 (2006) 1119-1125
43. Jacobs A., Neveling M., Horst M., et al. Alterations of neuropsychological function and cerebral glucose metabolism after cardiac surgery are not related only to intraoperative microembolic events. Stroke 29 (1998) 660-667
44. Barry S.J., Zeger S.L., Selnes O.A., et al. Quantitative methods for tracking cognitive change 3 years after coronary artery bypass surgery. Ann Thorac Surg 79 (2005) 1104-1109
45. Keith J.R., Cohen D.J., and Lecci L.B. Why serial assessments of cardiac surgery patients' neurobehavioral performances are misleading. Ann Thorac Surg 83 (2007) 370-373
46. Newman S., Stygall J., Hirani S., et al. Postoperative cognitive dysfunction after noncardiac surgery: a systematic review. Anesthesiology 106 (2007) 572-590
47. Rudolph J.L., Babikian V.L., Birjiniuk V., et al. Atherosclerosis is associated with delirium after coronary artery bypass graft surgery. J Am Geriatr Soc 53 (2005) 462-466
48. Vingerhoets G., Van Nooten G., and Jannes C. Effect of asymptomatic carotid artery disease on cognitive outcome after cardiopulmonary bypass. J Int Neuropsychol Soc 2 (1996) 236-239
49. Mackensen G.B., Ti L.K., Phillips-Bute B.G., et al. Cerebral embolization during cardiac surgery: impact of aortic atheroma burden. Br J Anaesth 91 (2003) 656-661
50. Verhoeven B.A., de Vries J.P., Pasterkamp G., et al. Carotid atherosclerotic plaque characteristics are associated with microembolization during carotid endarterectomy and procedural outcome. Stroke 36 (2005) 1735-1740
51. Newman M.F., Croughwell N.D., Blumenthal J.A., et al. Predictors of cognitive decline after cardiac operation. Ann Thorac Surg 59 (1995) 1326-1330
52. Rudolph J.L., Tilahun D., Treanor P.R., et al. Use of a large bore syringe creates significantly fewer high intensity transient signals (HITS) into a cardiopulmonary bypass system than a small bore syringe. Perfusion 21 (2006) 67-71
53. Groom R.C., Likosky D.S., Forest R.J., et al. A model for cardiopulmonary bypass redesign. Perfusion 19 (2004) 257-261
54. Reimers B., Corvaja N., Moshiri S., et al. Cerebral protection with filter devices during carotid artery stenting. Circulation 104 (2001) 12-15
55. Bokeriia L.A., Golukhova E.Z., Breskina N.Y., et al. Asymmetric cerebral embolic load and postoperative cognitive dysfunction in cardiac surgery. Cerebrovasc Dis 23 (2007) 50-56
56. Stroobant N., Van Nooten G., Van Belleghem Y., et al. Relation between neurocognitive impairment, embolic load, and cerebrovascular reactivity following on- and off-pump coronary artery bypass grafting. Chest 127 (2005) 1967-1976
57. Lund C., Hol P.K., Lundblad R., et al. Comparison of cerebral embolization during off-pump and on-pump coronary artery bypass surgery. Ann Thorac Surg 76 (2003) 765-770
58. Eifert S., Reichenspurner H., Pfefferkorn T., et al. Neurological and neuropsychological examination and outcome after use of an intra-aortic filter device during cardiac surgery. Perfusion 18 Suppl 1 (2003) 55-60
59. Nadareishvili Z.G., Beletsky V., Black S.E., et al. Is cerebral microembolism in mechanical prosthetic heart valves clinically relevant?. J Neuroimaging 12 (2002) 310-315
60. Browndyke J.N., Moser D.J., Cohen R.A., et al. Acute neuropsychological functioning following cardiosurgical interventions associated with the production of intraoperative cerebral microemboli. Clin Neuropsychol 16 (2002) 463-471
61. Fearn S.J., Pole R., Wesnes K., et al. Cerebral injury during cardiopulmonary bypass: emboli impair memory. J Thorac Cardiovasc Surg 121 (2001) 1150-1160
62. Braekken S.K., Reinvang I., Russell D., et al. Association between intraoperative cerebral microembolic signals and postoperative neuropsychological deficit: comparison between patients with cardiac valve replacement and patients with coronary artery bypass grafting. J Neurol Neurosurg Psychiatry 65 (1998) 573-576
63. Clark R.E., Brillman J., Davis D.A., et al. Microemboli during coronary artery bypass grafting. Genesis and effect on outcome. J Thorac Cardiovasc Surg 109 (1995) 249-258
64. Bossema E.R., Brand N., Moll F.L., et al. Perioperative microembolism is not associated with cognitive outcome three months after carotid endarterectomy. Eur J Vasc Endovasc Surg 29 (2005) 262-268
65. Lloyd A.J., Hayes P.D., London N.J., et al. Does carotid endarterectomy lead to a decline in cognitive function or health related quality of life?. J Clin Exp Neuropsychol 26 (2004) 817-825
66. Fearn S.J., Hutchinson S., Riding G., et al. Carotid endarterectomy improves cognitive function in patients with exhausted cerebrovascular reserve. Eur J Vasc Endovasc Surg 26 (2003) 529-536