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Evaluation of coated oxygenators in cardiopulmonary bypass systems and their impact on neurocognitive function

Department of Cardiac Surgery, University of Rostock, Rostock, Germany

Christian A Skrabal

Department of Cardiac Surgery, University of Rostock, Rostock, Germany

Bernd Westphal

Department of Cardiac Surgery, University of Rostock, Rostock, Germany

Guenther Kundt

Institute for Medical Informatics and Biometry, University of Rostock, Rostock, Germany

Brigitte Greim

Department of Neurology, University of Rostock, Rostock, Germany

Erwin Kunesch

Department of Neurology, University of Rostock, Rostock, Germany

Andreas Liebold

Department of Cardiac Surgery, University of Rostock, Rostock, Germany

Gustav Steinhoff

Department of Cardiac Surgery, University of Rostock, Rostock, Germany, gustav.steinhoff{at}med.uni-rostock.de

Introduction: Coronary artery bypass graft surgery (CABG) using cardiopulmonary bypass (CPB) is assumed to be associated with a decline of neurocognitive functions. This study was designed to analyse the neurocognitive function of patients with coronary heart disease before and after CABG and to determine possible protective effects of oxygenator surface coating on neurological outcome.

Methods: Forty patients scheduled for selective CABG were prospectively randomized into two groups of 20 patients each according to the type of hollow-fibre membrane oxygenator used. Non-coated oxygenators (Group A) were compared to phosphorylcholine (PC)- coated oxygenators (Group B). A battery of six neurological tests was administered preoperatively, 7 - 10 days and 4 - 6 months after surgery.

Results: One patient of Group A suffered from a perioperative stroke and died on postoperative day 3, presumably because of sudden heart failure. Two patients of Group A (10%) developed a symptomatic transitory delirious psychotic syndrome (STPT) on postoperative days 3 and 5. None of the patients of Group B had perioperative complications. The test analysis revealed a trend of declined neurocognitive function early after CABG, but did not show any difference in neurocognitive outcome between the two groups.

Discussion: PC coating of the oxygenators did not show any significant benefit on neurocognitive function after CABG using CPB.

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