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Ann Thorac Surg 1995;59:1289-1295
© 1995 The Society of Thoracic Surgeons

Symposium: Conference on Cardiopulmonary Bypass

Statement of Consensus on Assessment of Neurobehavioral Outcomes After Cardiac Surgery

John M. Murkin, MD, Stanton P. Newman, DPhil, David A. Stump, PhD, James A. Blumenthal, PhD

Department of Anaesthesia, University Hospital, University of Western Ontario, London, Ontario, Canada; Department of Psychiatry, University College London Medical School, London, United Kingdom; Department of Anesthesia, The Bowman Gray School of Medicine of Wake Forest University, Winston Salem, North Carolina; and Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina

Dr Murkin, Department of Anaesthesia, University Hospital, 339 Windermere Rd, London, Ont, Canada N6A 5A5.

The first 300 words of the full text of this article appear below.

At the recent meeting CNS Dysfunction After Cardiac Surgery: Defining the Problem, held December 10 and 11 in Fort Lauderdale, FL, a draft statement outlining proposed criteria for the assessment of central nervous system (CNS) outcomes after cardiac surgery was circulated beforehand to all registrants and invited speakers. The intent of the draft statement was to act as a focus for discussion by the audience of assembled experts from diverse disciplines including psychology, neuropsychology, neurology, neuroradiology, brain ischemia research, anesthesia, cardiovascular surgery, and epidemiology and biostatistics. After a 12-hour lecture program in which issues relevant to neurobehavioral outcome research were presented by a multidisciplinary group of international experts, the last 4 hours of the conference was devoted to an open discussion and critique of the draft Statement of Consensus. These proceedings were audiotaped and transcribed, and a version of the discussion, edited for syntax, follows.

For clarity, the approved Consensus Statement is presented first, followed by a transcription of the point by point discussion of each of the statements appearing in the original draft. Where possible, speakers have been identified and are listed at the end.

Consensus Statement (Approved)

  1. A spectrum of postoperative central nervous system (CNS) dysfunction both acute and persistent occurs in a proportion of patients after cardiac surgical procedures, including brain death, stroke, subtle neurologic signs, and neuropsychologic impairment.
  2. A number of patients presenting for a cardiac operation have preexisting CNS abnormalities. A patient's neurologic and neuropsychologic state needs to be assessed at a time prior to operation to provide accurate baseline information.
  3. The individual change in performance from baseline to a time after operation is essential to any evaluation of the impact of the operation or any intervention associated with it.
  4. When indicated, designs should incorporate the use of a control or comparison group.
  5. Because of the time constraints . . . [Full Text of this Article]




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