PMID- 31852087
OWN - NLM
STAT- MEDLINE
DCOM- 20191224
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 98
IP  - 50
DP  - 2019 Dec
TI  - Carotid artery blood flow velocities during open-heart surgery and its 
      association with delirium: A prospective, observational pilot study.
PG  - e18234
LID - 10.1097/MD.0000000000018234 [doi]
LID - e18234
AB  - The aim of this prospective observational single-centre pilot study was to 
      evaluate the association between alterations in carotid artery blood flow 
      velocities during cardiac surgery and postoperative delirium.Carotid artery blood 
      flow velocity was determined perioperatively at 5 different timepoints by duplex 
      sonography in 36 adult cardiac surgical patients. Delirium was assessed using the 
      Confusion Assessment Method for the ICU and the Intensive Care Delirium Screening 
      Checklist. Additionally, blood flow velocities in the middle cerebral arteries, 
      differences in regional cerebral tissue oxygenation and quantity and quality of 
      microemboli were measured.Delirium was detected in 7 of 36 patients. After 
      cardiopulmonary bypass carotid artery blood flow velocities increased by 
      +23 cm/second (95% confidence interval (CI) 9-36 cm/second) in non-delirious 
      patients compared to preoperative values (P = .002), but not in delirious 
      patients (+3 cm/second [95% CI -25 to 32 cm/second], P = .5781). Middle cerebral 
      artery blood flow velocities were higher at aortic de-cannulation in 
      non-delirious patients (29 cm/second [inter-quartile range (IQR), 
      24-36 cm/second] vs 12 cm/second [IQR, 10-19 cm/second]; P = .017). Furthermore, 
      brain tissue oxygenation was higher in non-delirious patients during surgery.Our 
      results suggest that higher cerebral blood flow velocities after aortic 
      de-clamping and probably also improved brain oxygenation might be beneficial to 
      prevent postoperative delirium.
FAU - Bernardi, Martin H
AU  - Bernardi MH
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
FAU - Wahrmann, Martin
AU  - Wahrmann M
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
FAU - Dworschak, Martin
AU  - Dworschak M
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
FAU - Kietaibl, Clemens
AU  - Kietaibl C
AD  - Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical 
      University of Vienna, Waehringer Guertel 18-20.
FAU - Ristl, Robin
AU  - Ristl R
AD  - Center for Medical Statistics, Informatics and Intelligent Systems, Medical 
      University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria.
FAU - Edlinger-Stanger, Maximilian
AU  - Edlinger-Stanger M
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
FAU - Lassnigg, Andrea
AU  - Lassnigg A
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
FAU - Hiesmayr, Michael J
AU  - Hiesmayr MJ
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
FAU - Weber, Ulrike
AU  - Weber U
AD  - Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, 
      Medical University of Vienna.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Aged
MH  - Blood Flow Velocity/*physiology
MH  - Cardiac Surgical Procedures/*adverse effects/methods
MH  - Carotid Artery, Common/diagnostic imaging/*physiopathology
MH  - Delirium/*diagnosis/etiology/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intraoperative Period
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - Postoperative Complications/*diagnosis/etiology/physiopathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Ultrasonography, Doppler, Duplex/*methods
PMC - PMC6922412
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2019/12/20 06:00
MHDA- 2019/12/25 06:00
PMCR- 2019/12/16
CRDT- 2019/12/20 06:00
PHST- 2019/12/20 06:00 [entrez]
PHST- 2019/12/20 06:00 [pubmed]
PHST- 2019/12/25 06:00 [medline]
PHST- 2019/12/16 00:00 [pmc-release]
AID - 00005792-201912130-00027 [pii]
AID - MD-D-19-05416 [pii]
AID - 10.1097/MD.0000000000018234 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2019 Dec;98(50):e18234. doi: 10.1097/MD.0000000000018234.