• J. Cardiothorac. Vasc. Anesth. · Jul 2022

    Review

    Neuromonitoring and Neurocognitive Outcomes in Cardiac Surgery: A Narrative Review.

    • Benjamin Milne, Thomas Gilbey, Livia Gautel, and Gudrun Kunst.
    • Department of Anaesthetics and Pain Medicine, King's College Hospital NHS Foundation Trust, London, UK.
    • J. Cardiothorac. Vasc. Anesth. 2022 Jul 1; 36 (7): 2098-2113.

    AbstractNeurocognitive dysfunction after cardiac surgery can present with diverse clinical phenotypes, which include postoperative delirium, postoperative cognitive dysfunction, and stroke, and it presents a significant healthcare burden for both patients and providers. Neurologic monitoring during cardiac surgery includes several modalities assessing cerebral perfusion and oxygenation (near-infrared spectroscopy, transcranial Doppler and jugular venous bulb saturation monitoring) and those that measure cerebral function (processed and unprocessed electroencephalogram), reflecting an absence of a single, definitive neuromonitor. This narrative review briefly describes the technologic basis of these neuromonitoring modalities, before exploring their use in clinical practice, both as tools to predict neurocognitive dysfunction, and with a bundle of interventions designed to optimize cerebral oxygen supply, with the aim of reducing postoperative delirium and cognitive dysfunction following cardiac surgery.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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