A5028912005- Cardiac, Anesthesia and Surgical Outcomes
- Optical Imaging and Spectroscopy Techniques
- Intensive Care Unit Cognitive Disorders
- Traumatic Brain Injury and Neurovascular Disturbances
- Cardiac and Coronary Surgery Techniques
- Anesthesia and Neurotoxicity Research
- Cardiovascular Function and Risk Factors
- Pulmonary Hypertension Research and Treatments
- Hemodynamic Monitoring and Therapy
- Aortic Disease and Treatment Approaches
- Infrared Thermography in Medicine
- Non-Invasive Vital Sign Monitoring
- Venous Thromboembolism Diagnosis and Management
- Photoacoustic and Ultrasonic Imaging
- Neurological Disease Mechanisms and Treatments
- S100 Proteins and Annexins
- Cardiac Valve Diseases and Treatments
- Congenital Heart Disease Studies
- Cardiac Arrest and Resuscitation
- Cerebrovascular and Carotid Artery Diseases
- Cardiovascular Health and Disease Prevention
- Acute Ischemic Stroke Management
Rigshospitalet
2016-2021
University of Copenhagen
2016-2021
Copenhagen University Hospital
2016-2020
Peking University
2019
Background: Cerebral injury is an important complication after cardiac surgery with the use of cardiopulmonary bypass. The rate overt stroke 1% to 2%, whereas silent strokes, detected by diffusion-weighted magnetic resonance imaging, are found in up 50% patients. It unclear whether a higher versus lower blood pressure during bypass reduces cerebral infarction these Methods: In patient- and assessor-blinded randomized trial, we allocated patients (70–80 mm Hg) or (40–50 target for mean...
Debilitating brain injury occurs in 1.6-5 % of patients undergoing cardiac surgery with cardiopulmonary bypass. Diffusion-weighted magnetic resonance imaging studies have reported stroke-like lesions up to 51 after surgery. The majority the seem be caused by emboli, but inadequate blood flow other mechanisms may increase ischaemia penumbra or cause watershed infarcts. During bypass, pressure can below lower limit cerebral autoregulation. Although much debated, constant provided bypass system...
Near-infrared spectroscopy (NIRS) is used worldwide to monitor regional cerebral oxygenation (rScO2) during cardiopulmonary bypass (CPB). Intervention protocols meant mitigate desaturation advocate increase mean arterial pressure (MAP) when occurs. However, the isolated effect of MAP on rScO2 uncertain. The aim present study was in a randomized, blinded design elucidate 2 distinct levels values CPB.We hypothesized that higher would be reflected values, lower frequency patients with...
Abstract OBJECTIVES Cardiac surgery is associated with risk of cerebral injury and mean arterial pressure (MAP) during cardiopulmonary bypass (CPB) suggested to be injury. The ‘Perfusion Pressure Cerebral Infarcts’ (PPCI) trial randomized patients undergoing coronary artery grafting (CABG) and/or aortic valve replacement a MAP 40–50 or 70–80 mmHg CPB found no difference in clinical imaging outcomes between the groups. We here present PPCI predefined secondary end points, consisting...
Background Cardiac surgery is associated with a risk of complications, including post‐operative cognitive dysfunction (POCD). In the randomized Perfusion Pressure Cerebral Infarcts (PPCI) trial, we allocated cardiac patients to either low‐target mean arterial pressure (40‐50 mm Hg) or high‐target (70‐80 Hg). The study found no difference in volume new ischemic cerebral lesions nor POCD, but 30‐day mortality tended be higher group. present did long‐term 3‐year follow‐up assess survival and...
Background Brain injury and cognitive dysfunction are serious complications after cardiac surgery. In the perfusion pressure cerebral infarcts (PPCI) trial, we allocated surgery patients to a mean arterial of either 70‐80 mm Hg (high‐target) or 40‐50 (low‐target) during cardiopulmonary bypass. this secondary analysis, aimed assess potential differences in domain‐specific patterns deterioration between allocation groups investigate any associations postoperative (POCD) with diffusion‐weighted...
Abstract Objective In this substudy of a randomized, clinical trial, we explored the sublingual microcirculation during cardiac surgery at 2 different levels blood pressure. We hypothesized that higher map CPB would cause MFI. Methods Thirty‐six patients undergoing CABG were included and randomized to either low (40‐50 mm Hg) or high (70‐80 MAP CPB. SDF video images recorded from mucosa. Recordings analyzed in blinded fashion quantify microcirculatory variables. Results target group was 45.0...
Abstract Near infrared spectroscopy (NIRS) has been used to evaluate regional cerebral tissue oxygen saturation (ScO 2 ) during the last decades. Perioperative management algorithms advocate maintain ScO , by maintaining or increasing cardiac output (CO), e.g. with fluid infusion. We hypothesized that would increase in responders a standardized challenge (FC) and relative changes CO correlate. This study is retrospective substudy of FLuid Responsiveness Prediction Using Extra Systoles (FLEX)...
Brain dysfunction is a serious complication after cardiac surgery. In the Perfusion Pressure Cerebral Infarcts trial, we allocated surgery patients to mean arterial pressure of either 70-80 or 40-50 mmHg during cardiopulmonary bypass (CPB). this secondary analysis, compared selected cerebral metabolites using magnetic resonance spectroscopy hypothesizing that postoperative decrease in occipital grey matter (GM) N-acetylaspartate-to-total-creatine ratio, indicative ischaemic injury, would be...
Near-infrared spectroscopy (NIRS) is a non-invasive method that reflects real-time cerebral oxygenation (rSO 2 ) by the use of two adhesive optodes placed on forehead patient. Frontal sinuses vary anatomically and large frontal sinus might compromise NIRS signal since are at skin surface superficial to underlying sinus. The aim this case-series was elucidate whether there difference in obligate changes rSO during cardiac surgery between patients with small as opposed anterior-posterior...