Cognitive evaluation of the patient exposed to cardiopulmonary bypass: A tool to determine the impact of the practice.

Abstract

Introduction: Despite the adverse effects of cardiopulmonary bypass (CPB) have been decreased during the las decades, cpostoperative cognitive decline is still frequent. Even considering that the ethilogy is multiple, no specific tool has been yet designed to assess the cognitive impact of CPB. In this regard, a new perfusión cognitive assessment batery (P-CAB) has been configured as a methodology to specifically evaluate the changes in cognitive performance of patients exposte to CPB, during the postoperative period, thus improving the results.. Metodology: A descriptive study was performed, in order to define the composition and methodology of application for P-CAB. Initially, a multidisciplinary cognitive assessment team (GEN) was configured. Then, a bibliographic review was carried out to identify the potential test that could compose the battery and a final selection was achieved by means of a focal group technique. Periodic training of the evaluators was initiated also, including the execution and correction of tests.. Results: P-CAB was successfully applied for 116 patients prior to surgery, the second day after ICU discharge and included in a follow-up after 4 months from the surgery. The applied tests were Phototest (PhT), Clock drawing test (CDT) and the visuospatial memory test derived form the Corsi block-taping test (VMT) that was digitalized in a mobile phone application. Discussion: P-CAB tests, individually act as a screening tool for severe cognitive alterations like dementia. Additionally, the whole observation of PCAB results, offers a wider observation of even subtler changes in cognitive performance, that could be identify the insult on specific areas of the brain, due to the observation of memory (semantic, episodic, and visuospatial), language, attention and executive functions. Further studies, including diagnosis with image, are required to confirm the correlations between the altered functions and the affected areas of the brain. Conclusión: P-CAB is a valuable tool that permits to observe the cognitive performance variation for patients exposed to CPB. Its correlation with physical alterations should be explored.