Monitoring During Cardiopulmonary Bypass
Despite dramatic advances in myocardial preservation during cardiac surgery, brain injury remains a common and serious complication . Although myocardial revascularization may be achieved on a beating heart, the majority of these surgeries, as well as all open-heart surgery, requires the use of cardiopulmonary bypass (CPB). The brain injury may be either diffuse or regional, with sequelae ranging from encephalopathy or stroke to subtle cognitive decline or disruptive personality changes [1, 2]. The most common injury mechanisms are cerebral embolism and/or hypoperfusion . Furthermore, the two mechanisms often coexist such that hypoperfusion exacerbates embolic injury by reducing the clearance of particulates or gas bubbles from the cerebral microcirculation .
KeywordsMultimodality neuromonitoring Cardiopulmonary bypass Pharmacologic Surgical Patient management Injury Neural structures Risk
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