Assessment of Neurocognitive Effect in Patients Undergoing Cardiopulmonary Bypass: A Prospective Longitudinal Study

Ahmed Jamal, Usman Iqbal, Aroosa Amjad, R. Iqbal, A. Abdullah
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Abstract

Objective: To assess neurocognitive effects in patients who underwent cardiopulmonary bypass. Study Design & Setting: Using non probability purposive sampling, a prospective study design was used to collect the data from in tertiary care hospitals with 60 beds in ICU. Methodology: Patients who underwent CPB having no history of psychological and mental illness was recruited for the said study. We used a short test of global mental status to measure cognitive performance called the “Mini-Mental State Examination (MMSE)”.Wilcoxon test was used to analyze the pre- and post-operative changes over MMSE. The Folstein test, often known as the mini-mental state examination (MMSE), is a 30-point survey that has been widely used in clinical and research contexts to evaluate cognitive impairment. Different parameters; temporal, spatial, alternate, recognition, and recall were evaluated. P-value ≤0.05 was considered as significant. Results: In this study, a significant fall in spatial, temporal, short term recall, long term recall, object recognition, alternate, reading, writing, read and act, and drawing in post-operative MMSE scores was observed as compared to pre-operative. However, there was no significant change in command so there is little or no effect on command parameters in pre-operative and post-operative cardiopulmonary bypass patients. There was a significant difference between pre-operation and post-operation total scores i.e., a fall in the ‘total’ score of neurocognition occurred after cardiopulmonary bypass. Practical implication Study finding may be used for practical implications in managing neurocognitive outcome in patients undergoing cardiopulomonary bypass. Conclusion: This research concludes that neurocognition is affected in patients who underwent CPB, with CPB itself a bigger risk factor in causing postoperative neurocognitive dysfunction. Keywords: Cardiopulmonary bypass, Mental health, Neurocoagnitive impairment, POCD
评估体外循环患者的神经认知效应:一项前瞻性纵向研究
目的:评价体外循环患者的神经认知功能。研究设计与设置:采用非概率目的抽样,采用前瞻性研究设计,收集三级医院60张ICU床位的数据。方法:接受CPB且无心理和精神病史的患者被招募参加上述研究。我们使用了一种简短的全球精神状态测试来衡量认知表现,称为“迷你精神状态检查(MMSE)”。采用Wilcoxon检验分析术前和术后MMSE的变化。福尔斯坦测试,通常被称为迷你精神状态检查(MMSE),是一项30分的调查,已广泛用于临床和研究环境中评估认知障碍。不同的参数;评估时间、空间、交替、识别和回忆。p值≤0.05为显著性。结果:在本研究中,与术前相比,术后MMSE得分在空间、时间、短期回忆、长期回忆、物体识别、交替、阅读、写作、阅读和行为以及绘画方面显著下降。然而,体外循环术前和术后患者的指挥参数没有明显变化,因此对指挥参数的影响很小或没有影响。术前与术后总评分差异有统计学意义,即体外循环术后神经认知总分下降。实际意义研究发现可用于处理行心肺搭桥术患者的神经认知结果的实际意义。结论:本研究认为CPB患者神经认知功能受到影响,CPB本身是导致术后神经认知功能障碍的更大危险因素。关键词:体外循环,心理健康,神经凝血功能障碍,POCD
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