Redesigning Cardiac Surgery to Reduce Neurologic Injury

Summary

Neurologic injuries are frequent and devastating complications following cardiac surgery. Previous work conducted by our research group and others has identified the principal mechanisms creating both overt and subtle neurologic injuries after cardiac surgery. Current work by our group has identified that the causes (thrombotic/lipid emboli, cerebral hypoperfusion \& hypotension, and gaseous emboli) of these injuries are byproducts of processes of surgical and perfusion care. This insight suggests that the redesign of clinical strategies and techniques to prevent the occurrence of these intraoperative sources of damage may provide an opportunity to reduce the risk of neurologic injury after cardiac surgery.

The goal of this research is to identify modifiable clinical strategies and techniques of surgical and perfusion care associated with the causes (thrombotic/lipid emboli, cerebral hypoperfusion \& hypotension, and gaseous emboli) of neurologic injury secondary to coronary artery bypass graft (CABG) surgery, and subsequently to redesign these processes to reduce a patient's risk of a neurologic injury.

Conditions

• Cardiovascular Disease
• Surgery

Interventions

OTHER

Quality improvement intervention

determine the effectiveness of adopting quality improvement strategies to reduce embolization, hypotension and cerebral desaturation

Sponsors & Collaborators

• MaineHealth

  collaborator OTHER

• Catholic Medical Center

  collaborator OTHER

• Somanetics Corporation

  collaborator INDUSTRY

• LivaNova

  collaborator INDUSTRY

• Maquet Cardiovascular

  collaborator INDUSTRY

• Northern New England Cardiovascular Disease Study Group

  collaborator UNKNOWN

• Luna Innovations

  collaborator INDUSTRY

• Agency for Healthcare Research and Quality (AHRQ)

  collaborator FED

• Dartmouth-Hitchcock Medical Center

  lead OTHER

Principal Investigators

• Donald S Likosky, Ph.D. · Dartmouth-Hitchcock Medical Center

• David J. Malenka, MD · Dartmouth-Hitchcock Medical Center

Eligibility

Min Age

40 Years

Max Age

89 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2002-10-31

Primary Completion

2011-08-31

Completion

2012-02-29

Countries

• United States

Study Locations