Decreased brain-derived neurotrophic factor levels may predict early perioperative neurocognitive disorder in patients undergoing coronary artery bypass surgery: A prospective observational pilot study - 14/05/21
, Ferit Çiçekçioğlu b, Mahmut Kılıç c, Mehtap Honca a, Dilşad Yıldız Miniksar d, Ayse Yesim Gocmen e, Osman Kaçmaz f, Hakan Öz aAbstract |
Study objective |
To determine the prognostic value of the change in intraoperative BDNF (Brain-derived neurotrophic factor) levels during cardiac surgery with cardiopulmonary bypass (CPB) on early perioperative neurocognitive disorder (PND).
Design |
Prospective observational pilot study.
Setting |
The study was performed in the Medical Faculty Hospital, from January 2020 to August 2020.
Patients |
45 adult patients undergoing elective coronary artery bypass surgery (CABG) with CPB.
Interventions |
None.
Measurements |
Cognitive function was evaluated 1 day before and 4 days after the surgery. Serum BDNF levels were measured at four time points (T1: after induction; T2: with aortic cross-clamp; T3: without aortic cross-clamp; T4: 4 days after surgery) by enzyme-linked immunosorbent assay.
Main results |
The incidence of PND was 37.8% four days after surgery. Serum BDNF (T2 and T4) levels were significantly lower in PND group compared to non- PND group (p = 0.003 and p = 0.016, respectively). Moreover, lactate, rSO2 (regional cerebral oxygen saturation), aortic cross-clamp time, CPB duration, and the amount of blood transfusion differed between the groups. Logistic regression analysis identified serum BDNF-T2, age, cross-clamp time, and rSO2-T2 as independent risk factors for PND. Based on the ROC analysis, the area under curve (AUC) of BDNF-T2 concentration for prediction of PND was 0.759 with sensitivity of 71.4% and specificity of 64.7% (p < 0.01).
Conclusion |
Intraoperative BDNF serum levels may be a useful biomarker in predicting PND in patients undergoing CABG surgery. More comprehensive studies is needed in order to confirm the effect of decreasing intraoperative BDNF serum levels on the development of PND.
Trial registration number |
NCT04250935 www.clinicaltrials.gov.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | The incidence of PND was 37.8% four days after cardiac surgery. |
• | BDNF levels are known to decrease in neurocognitive disorders. |
• | Decrease in BDNF levels during aortic cross clamping is a predictor for PND. |
• | Intraoperative BDNF levels may be a good predictor for PND after cardiac surgery. |
Keywords : Coronary artery bypass grafting, Postoperative cognitive dysfunction, Brain-derived neurotrophic factor, Predictor
Plan
Vol 71
Article 110235- août 2021 Retour au numéro
Article précédent
- The addition of clonidine to ropivacaine in rectus sheath nerve blocks for pediatric patients undergoing laparoscopic appendectomy: A double blinded randomized prospective study
- Mihaela Visoiu, Stefan Scholz, Marcus M. Malek, Philip C. Carullo
- Management of a parturient with seizure disorder and a vagus nerve stimulator
- Arthur Chyan, Sangeeta Kumaraswami, Suryanarayana Pothula
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?