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Plasma concentrations of nitric oxide products and cognitive dysfunction following coronary artery bypass surgery

Published online by Cambridge University Press:  29 April 2005

D. Harmon ,
N. Eustace ,
K. Ghori ,
M. Butler ,
S. O'Callaghan ,
A. O'Donnell ,
G. M. Moore-Groarke  and
G. Shorten
D. Harmon
Affiliation:
Walton Centre for Neurology and Neurosurgery, Liverpool, UK
N. Eustace
Affiliation:
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland
K. Ghori
Affiliation:
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland
M. Butler
Affiliation:
Cork University Hospital, Department of Biochemistry, Cork, Ireland
S. O'Callaghan
Affiliation:
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland
A. O'Donnell
Affiliation:
Cork University Hospital, Department of Cardiothoracic Surgery, Cork, Ireland
G. M. Moore-Groarke
Affiliation:
Cork clinic, Department of Psychology, Cork, Ireland
G. Shorten
Affiliation:
Cork University Hospital and University College Cork, Department of Anaesthesia and Intensive Care Medicine, Cork, Ireland
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Abstract

Summary

Background and objective: Prospective longitudinal studies now indicate that cognitive dysfunction following coronary artery bypass surgery (CABG) is both common and persistent. This dysfunction is due in part to the inflammatory response and cerebral ischaemia–reperfusion, with nitric oxide (NO) as an important mediator of both. We hypothesized that a clinically significant association exists between plasma concentrations of nitrate/nitrite (NO3−/NO2−) and cognitive dysfunction after CABG.

Methods: Cognitive assessment was performed on 36 adult patients the day before CABG, on the fourth postoperative day and 3 months postoperatively. Patient spouses (n = 10) were also studied.

Results: A new cognitive deficit was present in 22/36 (62%) 4 days postoperatively and in 16/35 (49%) of patients, 3 months postoperatively. Patients who had cognitive dysfunction 3 months postoperatively were more likely to have cognitive dysfunction and increased plasma NO3−/NO2− concentrations compared to the non-deficit group preoperatively (22.6 (9.2) vs. 27.6 (8.4)) (P = 0.002). Plasma NOx (NO3− plus NO2−) concentrations were greater in patients with cognitive dysfunction 3 months postoperatively, 2 h (24.2 (6.3) vs. 19.1 (5.2)) (P = 0.002), and 12 h postoperatively (24.8 (7.6) vs. 18.8 (5.6)) (P = 0.001). There was, however, a time course similarity in NOx elevations for both deficit and non-deficit groups.

Conclusions: Perioperative plasma NOx concentrations do not serve as an effective biomarker of cognitive deficit after CABG.

Keywords

CORONARY ARTERY BYPASS SURGERYMENTAL PROCESSES, cognitionHYPOXIA–ISCHAEMIA, brainBIOLOGICAL MARKERSREACTIVE NITROGEN SPECIES, nitric oxideNEUROPSYCHOLOGICAL TESTS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 4 , April 2005 , pp. 269 - 276
Copyright
2005 European Society of Anaesthesiology

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