ArticleCureus2025
Cerebral Hemodynamic Changes and Postoperative Brain Function in Patients Undergoing Cardiac Valve Surgery With Cardiopulmonary Bypass: A Prospective Cohort Study.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Pathogenesis of gaseous microemboli in cardiac surgery. a comprehensive overview of deairing procedures, operative interactions and risk factors to mitigate postoperative cerebral disorders.Journal of cardiothoracic surgery · 2026Review
- Predictive value of multimodal neurological monitoring in the postoperative neurological dysfunction after cardiovascular surgery with cardiopulmonary bypass.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background Cardiopulmonary bypass (CPB) during cardiac surgery disrupts cerebral hemodynamics, potentially leading to postoperative neurological complications such as delirium. Transcranial Doppler (TCD) offers non-invasive monitoring of cerebral blood flow alterations, yet its predictive value for delirium remains underexplored. This study aims to investigate the association between intraoperative cerebral hemodynamic changes monitored by TCD and postoperative delirium in patients undergoing cardiac valve surgery with CPB. Methods This prospective cohort study enrolled 184 elective cardiac valve surgery patients. TCD measured middle cerebral artery mean flow velocity (Vm), pulsatility index (PI), and resistance index (RI) at five perioperative time points: 24 hours preoperative (T1), five minutes post anesthesia induction (T2), five minutes intraoperative post-cross-clamping (T3), five minutes post resumption of cardiac beating (T4), and prior to operating room discharge (T5). Delirium was diagnosed using the Confusion Assessment Method for the ICU (CAM-ICU). Neuropsychological assessments using Richmond Agitation-Sedation Scale (RASS) and Mini-Mental State Examination (MMSE) were conducted preoperatively and at 24 and 48 hours postoperatively. Results Postoperative delirium occurred in 20 patients (10.9%). The delirium group demonstrated significantly longer CPB duration (143.2 ± 19.7 minutes versus 113.8 ± 16.4 minutes; P < 0.001) and aortic cross-clamp time (97.6 ± 15.3 minutes versus 72.4 ± 12.1 minutes; P < 0.001). Both groups exhibited cerebral hypoperfusion during CPB (T3-T4 versus T1: reduced Vm, elevated PI and RI; P < 0.05), with more severe disturbances in delirium patients (T3 Vm: 25.8 ± 3.7 cm/s versus 29.5 ± 4.0 cm/s; P < 0.001). Prior to operating room discharge (T5), delirium patients showed persistent hemodynamic abnormalities (Vm: 56.2 ± 5.0 cm/s versus 62.8 ± 5.2 cm/s; PI: 0.96 ± 0.07 versus 0.85 ± 0.06; P < 0.001) while non-delirium patients returned to baseline. Significant cognitive decline was observed in delirium patients (24-hour MMSE: 21.8 ± 2.1 versus 27.2 ± 1.4; P < 0.001). Conclusion Intraoperative TCD-detected cerebral hypoperfusion, characterized by reduction in Vm and elevated PI and RI, and prolonged CPB duration are independent predictors of postoperative delirium. Failure of postoperative cerebral hemodynamic recovery may contribute to the pathogenesis of delirium.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.