Identification of Factors Causing Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery With CPB

Study Overview
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Brief Summary
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The incidence of cognitive decline occurs in 53% of patients after cardiac surgery. Causes of POCD can be various: age, duration of cardiac bypass, medicaments and many others. The aim of this study is to determine factors causing postoperative cognitive dysfunction (POCD) and to identify which of them are most important

Detailed Description
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Prospective case-control study included patients undergoing cardiac at Clinic of Cardiac, Vascular and Thoracic Surgery, Lithuanian University of Health Sciences. Inclusion criteria is: 1) cardiac output > 35%; 2) no agents affecting central nervous system; 3) no neuropathology; 5) no multiple organ dysfunction. Patients will have to perform mini mental state examination (MMSE), Trial making, addenbrooke tests before and 7 days after surgery. Brain biomarkers glial fibrillary acid protein (GFAP) and neurofilaments will be taken after induction, 24 and 48 hours after surgery. Transcranial Doppler will be performed to evaluate a.cerebri media blood flow speed during surgery. After these test, the investigators are going to examine data about patient and operation, recognize factors causing POCD and identify the most important of them.

Official Title
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Identification of Factors Causing Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass (CPB)

Conditions
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Postoperative Cognitive Dysfunction

Intervention / Treatment
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* Diagnostic Test: blood sample for brain biomarkers


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Coronary artery bypass grafting or/and heart valve surgery; Patients age>18years Cardiac output >35% Exclusion Criteria: Patient disagreement; Diseases causing cognitive dysfunction; Multi organic deficiency; Agents affecting central nervous system

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: blood sample for brain biomarkers|Transcranial Doppler will be performed to evaluate a.cerebri media blood flow speed during surgery.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain blood flow speed changes during surgery and correlation with POCD | Transcranial Doppler will be performed to evaluate a.cerebri media blood flow speed during surgery using the 2MHz TCD ultrasound transducer over the temporal area. By adjusting the probe the curve of arteria will appear. Target measurement- mean flow velocity (MFV is measured in cm/s). | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain biomarker GFAP concentration chances before and after surgery and correlation with POCD. | Blood sample for brain biomarkers GFAP will be taken after induction, 24 and 48 hours after surgery. GFAP concentration in blood serum is measured in ng/ml | 3 years | 
| Brain biomarker neurofilaments concentration chances before and after surgery and correlation with POCD. | Blood sample for brain biomarker neurofilaments will be taken after induction, 24 and 48 hours after surgery. GFAP concentration in blood serum is measured in pg/ml | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiac, surgery, postoperative cognitive dysfunction, bypass, brain biomarkers, transcranial Doppler