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• W3043308967 abstract "<br><b>Background:</b> Neurocognitive dysfunction is a common complication of coronary artery bypass grafting (CABG) with incidence of 19–38%. The miniaturized cardiopulmonary bypass (MCPB) system was developed to reduce hemodilution and inflammation and provides better cerebral protection than conventional cardiopulmonary bypass (CCPB). In a meta-analysis, MCPB was associated with a 10-fold reduction in the incidence of strokes. However, its effect on postoperative cognitive decline (POCD) is unknown. We assessed if MCPB decreases POCD after CABG and compared the risk factors. <b>Methods:</b> A total of 71 Asian patients presenting for elective CABG at a tertiary center were enrolled. They were randomly assigned to MCPB (<i>n</i> = 36) or CCPB group (<i>n</i> = 35) and followed up in a single-blinded, prospective, randomized controlled trial. The primary outcome was POCD as measured by the repeatable battery of neuropsychological status (RBANS). Inflammatory markers (tumor necrosis factor-alpha and interleukin-6), hematocrit levels, and neutron-specific enolase (NSE) levels were studied. <b>Results:</b> Overall, the incidence of POCD at 3 months was 50%, and this was not significantly different between both groups (51.4 vs 50.0%,<i> P </i>= 0.90). Having <6 years of formal education [risk ratio (RR) = 3.014, 95% confidence interval (CI) = 1.054–8.618,<i> P </i>= 0.040] was significantly associated with POCD in the CCPB group, while the lowest hematocrit during cardiopulmonary bypass was independently associated with POCD in the MCPB group (RR = 0.931, 95% CI = 0.868–0.998,<i> P </i>= 0.044). The postoperative inflammatory markers and NSE levels were similar between the two groups. <b>Conclusions:</b> This study shows that the MCPB was not superior to CCPB with cell salvage and biocompatible tubing with regard to the neurocognitive outcomes measured by the RBANS.<br>" @default.
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• W3043308967 date "2020-01-01" @default.
• W3043308967 modified "2023-10-01" @default.
• W3043308967 title "Comparison of postoperative cognitive decline in patients undergoing conventional vs miniaturized cardiopulmonary bypass: A randomized, controlled trial" @default.
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• W3043308967 doi "https://doi.org/10.4103/aca.aca_192_18" @default.
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