CPB EFFECTS ON NEUROPSYCHOLOGICAL PERFORMANCE

描述：以前的研究报告了术后心脏功能的下降。 体外循环患者的认知功能。 不幸的是，这些研究依赖于评估工具和研究。 设计不允许对潜在的 认知变化是导致这些表现下降的原因。这项研究 程序将分析CPB的神经心理后果，使用 最先进的计算机化认知测试。不像报纸和 在这类研究中经常使用的铅笔仪器，这个测试电池是 旨在区分感觉运动的角色(即，非联想的) 和认知(即联想)过程对术后表现的影响 改变。精神运动速度、注意力和记忆力的测试用于 比较术前(1-3天)和术后(2-3周和6个月) 体外循环患者与健康对照组、非体外循环患者的比较 血管手术患者和心脏病患者接受治疗 经皮冠状动脉腔内成形术(PCTA) 这个程序的另一个独特之处是它分析了 患者对工作表现的自我评价与客观测量之间的关系 性能。此前的研究报告称，CPB患者中 经常被抱怨的术后缺陷并不是 赤字最有可能被衡量。据推测， 对术后表现缺陷的主观认识将取决于 受影响的潜在神经心理过程是否是陈述性的 或本质上的非陈述性。 最后，最近的研究表明，钙通道阻滞剂有 暴露在大脑侮辱中的患者的神经保护作用。虽然 大约三分之一的CPB患者接受钙通道阻滞剂治疗 心脏病的治疗，只有一项发表的研究检查了 钙通道阻滞剂在体外循环中的潜在神经保护作用 病人。本节目将系统分析两者之间的关系 钙通道阻滞剂的使用及其神经心理学后果 警察公共关系科。 总而言之，这个研究项目的中心目标是更准确地 描述与CPB相关的认知变化的性质，确定 决定患者术后变化意识的因素， 并评价钙通道潜在的神经保护作用 体外循环患者使用的阻滞剂。预计这项研究计划将 对评估新的外科技术做出了重大贡献 以及对如何最好地管理关键变量的理解 在体外循环中保留脑功能。

DESCRIPTION: Previous studies have reported postoperative declines in cognitive performance in cardiopulmonary bypass (CPB) patients. Unfortunately, these studies relied on assessment instruments and research designs that did not permit specific conclusions about the underlying cognitive changes responsible for these performance declines. This research program will analyze the neuropsychological consequences of CPB using state-of-the-art, computerized, cognitive tests. Unlike the paper and pencil instruments routinely used in such studies, this test battery was designed to distinguish the roles of sensorimotor (i.e., non-associative) and cognitive (i.e., associative) processes in postoperative performance changes. Tests of psychomotor speed, attention, and memory are used to compare pre- (1-3 days) and postoperative (2-3 weeks and 6 months) performance on CPB patients with that of healthy control subjects, non-CPB vascular surgery patients, and heart disease patients treated with percutaneous transluminal coronary angioplasty (PCTA). Another unique aspect of this program is that it analyzes the relationship between patients' self-appraisals of performance and objective measures of performance. Previous studies have reported that CPB patients who most frequently complained of postoperative deficits were not the ones in whom deficits were most likely to be measured. It is hypothesized that subjective awareness of a postoperative performance deficit will depend upon whether the affected underlying neuropsychological processes are declarative or non-declarative in nature. Finally, recent research has revealed that calcium channel blockers have neuroprotective effects in patients exposed to cerebral insults. Although about 1 in 3 CPB patients receives calcium channel blockers for the treatment of heart disease, only one published study has examined the potential neuroprotective effects of calcium channel blockers in bypass patients. This program will systematically analyze the relationship between use of calcium channel blockers and the neuropsychological consequences of CPB. In summary, the central goals of this research program are to more precisely delineate the nature of the cognitive changes associated with CPB, identify the factors that determine the patient's awareness of postoperative changes, and evaluate the potential neuroprotective effects of calcium channel blockers in CPB patients. It is anticipated that this research program will contribute significantly both to the evaluation of new surgical technologies and to the understanding of how to best manage variables critical to preserving cerebral function during CPB.