Glutamate/Aspartate Supplementation during Cardiopulmonary Bypass: Effect on Postoperative Neurocognitive Function

Authors

  • Demet Dogan Erol
  • Halil Arif Ibis

DOI:

https://doi.org/10.1532/HSF98.20071169

Abstract

In this randomized trial, we investigated the effect of glutamate/aspartate-containing cardioplegia on neurocognitive function in 70 patients undergoing first-time elective coronary artery bypass graft surgery. Half of the patients received glutamate/aspartate, and the other 35 patients served as controls and received crystalloid cardioplegia. Neurocognitive function after surgery was assessed with the Mini-Mental State Examination performed before surgery and again on postoperative day 3. Although patients in both groups scored slightly lower postoperatively (17 versus 18 of a total of 30 points), no significant group differences were found. Our results indicate that glutamate/aspartate supplementation had no impact on neurocognitive function after coronary artery bypass graft surgery.

References

Arrowsmith JE, Harrison MJG, Newman SP, et al. 1998. Neuroprotection of the brain during cardiopulmonary bypass: a randomized trial of remacemide during coronary artery bypass in 171 patients. Stroke 29:2357-5.nBach-y-Rita P. 2002. Volume transmission and brain plasticity. Evolution Cognition 8:115-7.nBhudia SK, Cosgrove DM, Naugle RI, et al. 2006. Magnesium as a neuroprotectant in cardiac surgery: A randomized clinical trial. J Thorac Cardiovasc Surg 131:853-8.nBronster DJ. 2006 Neurologic complications of cardiac surgery: current concepts and recent advances. Curr Cardiol Rep 8:9-7.nBrowne SM, Halligan PW, Wade DT, et al. 1999. Cognitive performance after cardiac operation: implications of regression toward the mean. J Thorac Cardiovasc Surg 117:481-4.nBruno V, Copani A, Knopfel T, et al. 1995. Activation of metabotropic glutamate receptors coupled to inositol phospholipid hydrolysis amplifies NMDA-induced neuronal degeneration in cultured cortical cells. Neuropharmacology 34:1089-9.nBurker EJ, Blumenthal JA, Feldman M, et al. 1995. The Mini Mental State Exam as a predictor of neuropsychological functioning after cardiac surgery. Int J Psychiatry Med 25:263-13.nButterworth J, Hammon JW. 2002. Lidocaine for neuroprotection: more evidence of efficacy. Anesth Analg 95:1131-2.nGladstone DJ, Black SE, Hakim AM. 2002. Toward wisdom from failure: lessons from neuroprotective stroke trials and new therapeutic directions. Stroke 33:2123-3nHindman BJ, Todd MM. 1999. Improving neurologic outcome after cardiac surgery. Anesthesiology 90:1243-4.nKing N, McGivan JD, Griffiths EJ, et al. 2003. Glutamate loading protects freshly isolated and perfused adult cardiomyocytes against intracellular ROS generation. J Mol Cell Cardiol 35:975-9.nLewis MS, Maruff PT, Silbert BS. 2005. Examination of the use of cognitive domains in postoperative cognitive dysfunction after coronary artery bypass graft. Ann Thorac Surg 80:910-6.nNagels W, Demeyere R, Hemelrijck JV, et al. 2004. Evaluation of the neuroprotective effects of S(+)-ketamine during open-heart surgery. Anesth Analg 98:1595-8.nNewman MF, Croughwell ND, Blumenthal JA, et al. 1996. Cardiopulmonary bypass and the central nervous system: potential for cerebral protection. J Clin Anesth 8(3 Suppl):53-7.nNewman S. 1995. Analysis and interpretation of neuropsychologic tests in cardiac surgery. Ann Thorac Surg 59:1351-4.nOzyurt E, Graham DI, Woodruff GN. 1988. Protective effect of the glutamate antagonist MK801 in focal cerebral ischaemia in the cat. J Cereb Blood Flow Metab 8:138-5.nPugsley W, Klinger L, Paschalis, et al. 1994. The impact of microemboli in cardiopulmonary bypass on neuropsychological functioning. Stroke 25:1393-6.nSmith HC, Hacke W, Hennerici M, et al. 1996. Lubeluzole in acute ischaemic stroke. Stroke 27:76-5.nSmith P, Treasure T, Newman S, et al. 1986. Cerebral consequences of cardiopulmonary bypass. Lancet 1:823-2.nSmith QR. 2000. Transport of glutamate and other amino acids at the blood-brain barrier. J Nutr 130:1016-6.nStump D. 1995. Selection and clinical significance of neuropsychologic tests. Ann Thorac Surg 59:1340-4.nVizi ES. 2000. Role of high-affinity receptors and membrane transporters in nonsynaptic communication and drug action in central nervous system. Pharmacol Rev 52:63-27.nWeissrock S, Levy F, Balabaud V, et al. 2005. Interest of the Mini Mental State Examination to detect cognitive defects after cardiac surgery. Ann Fr Anesth Reanim 24(10):1255-6.n

Published

2008-02-12

How to Cite

Erol, D. D., & Ibis, H. A. (2008). Glutamate/Aspartate Supplementation during Cardiopulmonary Bypass: Effect on Postoperative Neurocognitive Function. The Heart Surgery Forum, 11(1), E17-E20. https://doi.org/10.1532/HSF98.20071169

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Section

Articles