Cerebral dysfunction after cardiopulmonary bypass: aetiology, manifestations and interventions

Abstract

Central nervous system dysfunction following cardiac surgery remains a significant cause of morbidity and mortality, with the reported incidence of dysfunction varying widely between studies. Microemboli and global cerebral hypoperfusion are implicated as the major aetiologies of CNS impairment. Preoperative and intraoperative variables influencing the patient's risk of complications remain controversial. Based on a review of previous studies, this paper outlines the major causes and manifestations of CNS impairment as well as the intraoperative interventions currently advocated to improve the cerebral outcome of cardiac patients.