P0342 - Neuropsychological changes in patients after normothermic versus hypothermic CABG - randomized trial

Abstract

Aim:

to assess changes in cognitive functioning of Coronary Artery Bypass Grafting patients including effect of hypothermia and normothermia.

Methods:

Randomly selected normothermic (N, n=30) and hypothermic (H, n=21) patients were assessed 3-10 days before and 7-10 days after CABG using Bourdon Test, RAVLT, Tower of Hanoi Test, TMT: A&B, Benton Visual Retention Test, Digit Span, Digit Symbol, Verbal Fluency Test: Supermarket, Raven and Vocabulary Scales. Cognitive impairment rating (CIR) was defined as at least 1 SD scores deterioration, or change into worse category in at least 20% of tests.

Results:

Cognitive impairment was observed in 10 out of 12 tests. Changes were significantly greater in H-group in immediate recall visual memory, visual-motor coordination and working memory and in N-group in immediate verbal recall. Regarding mean changes impairment of immediate visual memory were observed in 60% of patients, whereas impairment of delayed recall auditory-verbal memory, immediate verbal memory, psychomotor speed, visual perception, language, attention -in 20-30%. The changes were similar for both methods (p=0.465). In N-group deterioration was observed in 26.7%, improvement in 5% of measures; in H-group deterioration– 28.6%, improvement- 7%. On average deterioration of at least 1 category was observed in 3 of 11 tests. CIR was met in 64.7% of the whole sample. There was no significant differences between the methods according to this criterion (N- 60%; H- 71.4%).

Conclusions:

CABG with extracorporeal circulation influences on cognitive functioning. Results suggest impairment in the field of coordinating complex cognitive processes rather than executive functions regardless of method used during CABG.