الفهرس | Only 14 pages are availabe for public view |
Abstract Neuropsychological complications such as effective changes, depressive mood and decreased attention and memory and concentration abilities may occur in 20% 75% of the patients after open heart surgery. This is a prospective study on patients who will undergo different openheart procedures. The aim of this study is to determine the incidence of neuropsychiatric complications following openheart operations; and to identify the possible risk factors (pre, intra, and postoperative) of statistical significance that may correlate with such complications, hoping to minimize their incidence in future. When analyzing the predisposing risk factors for neuropsychiatric complications in the present study, the following preoperative factors were found significant: Age more than 43.93 years, associated hypertension, associated DM, type of surgical procedures of significance as follows; double valve replacement alone or associated with tricuspid valve repair, mitral valve replacement with tricuspid valve repair. Pre CPB hypotention, bleeding, arrhythmia, hyperkalemia, and acidosis, duration pre CPB more than 70 minutes. Intraoperative factors as: acidosis during CPB, acidosis during aortic cross clamp, hyperkalemia during CPB, hyperkalemia during aortic cross clamp, CPB time more than 141.84 minutes, prolonged aortic cross clamp time more than 99.65 minutes. Higher temperature during CPB more than 36.78 C, and lower blood pressure CPB less than 22.78 mmHg. Post CPB bleeding, hypotension, weaning of CPB with inotrops, valve calcification, presence of thrombus. Postoperative inotropic support, postoperative systolic blood pressure less than 84.37 mmHg, or more than 170 mmHg, postoperative diastolic blood pressure less than 47.59 mmHg or more than 100.63 mmHg. postoperative bleeding, low COP, arrhythmia, acidosis, hyperkalemia, renal impairment, higher temperature more than 39.15 C, prolonged time for regain of consciousness more than 247.5 minutes. Regain of consciousness with irritability or convulsion and prolonged ICU stay more than 4.66 days was also noted to be associated with incidence of neurological complications. |