CPB EFFECTS ON NEUROPSYCHOLOGICAL PERFORMANCE

描述：先前的研究报告了术后 心肺转流（CPB）患者的认知表现。 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 导致这些表现下降的认知变化。 本研究 该计划将分析CPB的神经心理学后果， 最先进的计算机化认知测试 不像报纸和 在这些研究中常规使用的铅笔仪器，这个测试电池是 设计用于区分感觉运动的作用（即，非关联） 和认知（即，关联）过程 变化 心理速度、注意力和记忆力的测试通常用于 比较术前（1-3天）和术后（2-3周和6个月） CPB患者的性能与健康对照受试者的性能，非CPB 血管手术患者和心脏病患者 经皮腔内冠状动脉成形术（PCTA）。 这个程序的另一个独特之处在于它分析了 患者对表现的自我评价和客观测量之间的关系， 性能 以前的研究报告说，CPB患者谁最 经常抱怨术后缺陷的人并不是那些 赤字最有可能被衡量。 它是假设 术后表现缺陷的主观意识将取决于 受影响的潜在神经心理过程是否是陈述性的 或非声明性的。 最后，最近的研究表明，钙通道阻滞剂 神经保护作用的患者暴露于脑损伤。 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，只有一项已发表的研究检查了 钙通道阻滞剂在体外循环中的潜在神经保护作用 患者 本节目将系统分析 钙通道阻滞剂的使用及其神经心理学后果 CPB。 总之，这项研究计划的中心目标是更准确地 描述与CPB相关的认知变化的性质， 决定患者术后变化意识的因素， 并评估钙通道的潜在神经保护作用 CPB患者中的阻滞剂。 预计这项研究计划将 对评估新的外科技术 以及了解如何最好地管理对 在体外循环过程中保护脑功能

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.