Determination of Neurocognitive Changes Using Electroencephalography and the Mini-Mental Test in Coronary Bypass Patients Who Underwent Operation with Pulsatile and Non-Pulsatile Cardiopulmonary Bypass
Keywords: Electroencephalogram, mini-mental state examination, neurocognitive change, non-pulsatile bypass, pulsatile bypass
Introduction: The aim of this study was to compare the neurocognitive effects of pulsatile and non-pulsatile perfusion using electroencephalography and the Mini-Mental State Examination (MMSE) in patients undergoing coronary bypass surgery. Patients and Methods: We created two groups, each containing 11 consecutive randomized patients, who were candidates for coronary bypass surgery. Pulsatile cardiopulmonary bypass (CPB) was conducted in Group I, and non-pulsatile CPB was conducted in Group II. An electroencephalogram (EEG) was performed preoperatively, intraoperatively, 15 minutes after placement of the cross-clamp, and seven days postoperatively. The MMSE was performed preoperatively and on postoperative day seven. Results: In both groups, pathological EEG waves were detected intraoperatively. However, no statistically significant difference was found between the groups (p> 0.05). Urine output was significantly higher at postoperative day1 in Group I. Overall urine drainage was higher in Group I, but the difference was not statistically significant. Diabetes mellitus, hypercholesterolemia, hypertension, cross-clamp, and perfusion time did not have a significant impact on the formation of pathological EEG waves. The difference between pre- and postoperative MMSE scores was not statistically significant (p> 0.05). Conclusion: No remarkable superiority was shown between CPB pulsatile and non-pulsatile perfusion in our study. Improving physiology of perfusion techniques during CPB and performing further studies on patients at high risk for organ perfusion would suggest more comprehensive perfusion flow strategies.