A method for identifying mechanisms of neurologic injury from cardiac surgery
A method for linking discrete surgical and perfusion-related processes of care with cerebral emboli, cerebral oxyhemoglobin desaturation, and hemodynamic changes may offer opportunities for reducing overall neurologic injury for patients undergoing cardiac surgery. An intensive intraoperative neurol...
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| Veröffentlicht in: | The Heart surgery forum 2004-01, Vol.7 (6), p.348-352 |
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| container_title | The Heart surgery forum |
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| creator | Likosky, Donald S Groom, Robert C Clark, Cantwell Forest, Richard J Kramer, Robert S Morton, Jeremy R Ross, Cathy S Sabadosa, Kathryn A O'Connor, Gerald T |
| description | A method for linking discrete surgical and perfusion-related processes of care with cerebral emboli, cerebral oxyhemoglobin desaturation, and hemodynamic changes may offer opportunities for reducing overall neurologic injury for patients undergoing cardiac surgery.
An intensive intraoperative neurologic and physiologic monitoring approach was developed and implemented. Mechanisms likely to produce embolic (cerebral emboli), hypoperfusion (oxyhemoglobin desaturation), and hypotensive (hemodynamic changes) neurologic injuries were monitored and synchronized with the occurrence of surgical and perfusion clinical events/techniques using a case video.
The system was tested among 32 cardiac surgery patients. Emboli were measured in the cerebral arteries and outflow of the cardiopulmonary bypass circuit among nearly 75% and 85% of patients, respectively. Oxyhemoglobin desaturation was measured among nearly 70% of patients. Hemodynamic information was recorded in 100% of patients.
We developed and successfully implemented a method for detailed real-time associations between processes of clinical care and precursors of neurologic injury. Knowledge of this linkage will result in the redesign of clinical care to reduce a patient's risk of neurologic injury. |
| doi_str_mv | 10.1532/HSF98.20041088 |
| format | Article |
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An intensive intraoperative neurologic and physiologic monitoring approach was developed and implemented. Mechanisms likely to produce embolic (cerebral emboli), hypoperfusion (oxyhemoglobin desaturation), and hypotensive (hemodynamic changes) neurologic injuries were monitored and synchronized with the occurrence of surgical and perfusion clinical events/techniques using a case video.
The system was tested among 32 cardiac surgery patients. Emboli were measured in the cerebral arteries and outflow of the cardiopulmonary bypass circuit among nearly 75% and 85% of patients, respectively. Oxyhemoglobin desaturation was measured among nearly 70% of patients. Hemodynamic information was recorded in 100% of patients.
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An intensive intraoperative neurologic and physiologic monitoring approach was developed and implemented. Mechanisms likely to produce embolic (cerebral emboli), hypoperfusion (oxyhemoglobin desaturation), and hypotensive (hemodynamic changes) neurologic injuries were monitored and synchronized with the occurrence of surgical and perfusion clinical events/techniques using a case video.
The system was tested among 32 cardiac surgery patients. Emboli were measured in the cerebral arteries and outflow of the cardiopulmonary bypass circuit among nearly 75% and 85% of patients, respectively. Oxyhemoglobin desaturation was measured among nearly 70% of patients. Hemodynamic information was recorded in 100% of patients.
We developed and successfully implemented a method for detailed real-time associations between processes of clinical care and precursors of neurologic injury. Knowledge of this linkage will result in the redesign of clinical care to reduce a patient's risk of neurologic injury.</description><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Humans</subject><subject>Intraoperative Care - methods</subject><subject>Monitoring, Physiologic - methods</subject><subject>Nervous System Diseases - diagnosis</subject><subject>Nervous System Diseases - etiology</subject><subject>Nervous System Diseases - prevention & control</subject><subject>Treatment Outcome</subject><issn>1098-3511</issn><issn>1522-6662</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkD1PwzAQhi0EolBYGZEnthT7_JFkrCpKkYoYgDly_NG6SuJiJ0P_PYEWMd3p9LyvTg9Cd5TMqGDwuHpflsUMCOGUFMUZuqICIJNSwvm4k7LImKB0gq5T2hECEkBeogkVuSxzAlfodY5b22-DwS5E7I3teu8OvtuMZ71VnU9twsHhzg4xNGHjNfbdbogH7GJosVbReKVxGuLGxsMNunCqSfb2NKfoc_n0sVhl67fnl8V8nWkmWZ-pvNYU7PiwAl5rV1juhCxBCWA1rV1uKFF1nTPGjTSGu1xoVnImqaZcg2BT9HDs3cfwNdjUV61P2jaN6mwYUiVzkJJwPoKzI6hjSClaV-2jb1U8VJRUPwKrX4HVn8AxcH9qHurWmn_8ZIx9A1Nea8s</recordid><startdate>20040101</startdate><enddate>20040101</enddate><creator>Likosky, Donald S</creator><creator>Groom, Robert C</creator><creator>Clark, Cantwell</creator><creator>Forest, Richard J</creator><creator>Kramer, Robert S</creator><creator>Morton, Jeremy R</creator><creator>Ross, Cathy S</creator><creator>Sabadosa, Kathryn A</creator><creator>O'Connor, Gerald T</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040101</creationdate><title>A method for identifying mechanisms of neurologic injury from cardiac surgery</title><author>Likosky, Donald S ; Groom, Robert C ; Clark, Cantwell ; Forest, Richard J ; Kramer, Robert S ; Morton, Jeremy R ; Ross, Cathy S ; Sabadosa, Kathryn A ; O'Connor, Gerald T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c363t-a7bc12e088a24bcf8e4f5692a523b1bf7d10abb7334d6dd4f75c394361c14c253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Humans</topic><topic>Intraoperative Care - methods</topic><topic>Monitoring, Physiologic - methods</topic><topic>Nervous System Diseases - diagnosis</topic><topic>Nervous System Diseases - etiology</topic><topic>Nervous System Diseases - prevention & control</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Likosky, Donald S</creatorcontrib><creatorcontrib>Groom, Robert C</creatorcontrib><creatorcontrib>Clark, Cantwell</creatorcontrib><creatorcontrib>Forest, Richard J</creatorcontrib><creatorcontrib>Kramer, Robert S</creatorcontrib><creatorcontrib>Morton, Jeremy R</creatorcontrib><creatorcontrib>Ross, Cathy S</creatorcontrib><creatorcontrib>Sabadosa, Kathryn A</creatorcontrib><creatorcontrib>O'Connor, Gerald T</creatorcontrib><creatorcontrib>Northern New England Cardiovascular Disease Study Group, Lebanon, New Hampshire</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Heart surgery forum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Likosky, Donald S</au><au>Groom, Robert C</au><au>Clark, Cantwell</au><au>Forest, Richard J</au><au>Kramer, Robert S</au><au>Morton, Jeremy R</au><au>Ross, Cathy S</au><au>Sabadosa, Kathryn A</au><au>O'Connor, Gerald T</au><aucorp>Northern New England Cardiovascular Disease Study Group, Lebanon, New Hampshire</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A method for identifying mechanisms of neurologic injury from cardiac surgery</atitle><jtitle>The Heart surgery forum</jtitle><addtitle>Heart Surg Forum</addtitle><date>2004-01-01</date><risdate>2004</risdate><volume>7</volume><issue>6</issue><spage>348</spage><epage>352</epage><pages>348-352</pages><issn>1098-3511</issn><eissn>1522-6662</eissn><abstract>A method for linking discrete surgical and perfusion-related processes of care with cerebral emboli, cerebral oxyhemoglobin desaturation, and hemodynamic changes may offer opportunities for reducing overall neurologic injury for patients undergoing cardiac surgery.
An intensive intraoperative neurologic and physiologic monitoring approach was developed and implemented. Mechanisms likely to produce embolic (cerebral emboli), hypoperfusion (oxyhemoglobin desaturation), and hypotensive (hemodynamic changes) neurologic injuries were monitored and synchronized with the occurrence of surgical and perfusion clinical events/techniques using a case video.
The system was tested among 32 cardiac surgery patients. Emboli were measured in the cerebral arteries and outflow of the cardiopulmonary bypass circuit among nearly 75% and 85% of patients, respectively. Oxyhemoglobin desaturation was measured among nearly 70% of patients. Hemodynamic information was recorded in 100% of patients.
We developed and successfully implemented a method for detailed real-time associations between processes of clinical care and precursors of neurologic injury. Knowledge of this linkage will result in the redesign of clinical care to reduce a patient's risk of neurologic injury.</abstract><cop>United States</cop><pmid>15769702</pmid><doi>10.1532/HSF98.20041088</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | The Heart surgery forum, 2004-01, Vol.7 (6), p.348-352 |
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| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - methods Humans Intraoperative Care - methods Monitoring, Physiologic - methods Nervous System Diseases - diagnosis Nervous System Diseases - etiology Nervous System Diseases - prevention & control Treatment Outcome |
| title | A method for identifying mechanisms of neurologic injury from cardiac surgery |
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