Kumpaitiene et al.[2424 Kumpaitiene B, Svagzdiene M, Drigotiene I, Sirvinskas E, Sepetiene R, Zakelis R, et al. Correlation among decreased regional cerebral oxygen saturation, blood levels of brain injury biomarkers, and cognitive disorder. J Int Med Res. 22018;46(9):3621-9.], 2018 |
Prospective observational study |
59/0 |
Erythromycin (rSO2, NSE and GFAP) |
22 (37) on POD10 |
No significant changes in blood GFAP level occurred in any patients; decreased rSO2 and increased NSE level did not correlate with rate of POCD |
Erythromycin |
|
Thomaidou et al.[2525 Thomaidou E, Argiriadou H, Vretzakis G, Megari K, Taskos N, Chatzigeorgiou G, et al. Perioperative use of erythromycin reduces cognitive decline after coronary artery bypass grafting surgery: a pilot study. Clin Neuropharmacol. 2017;40(5):195-200.], 2017 |
Prospective randomized pilot study |
40/0 |
Erythromycin (25 mg/kg) vs. control (Serum IL-1, IL-6 and tau) |
19 (47.4) vs. 16 (76.2) just after hospital discharge, and 6 (31.6) vs. 38 (95.2) in 3 months |
|
Erythromycin |
|
Kok et al.[2626 Kok WF, Koerts J, Tucha O, Scheeren TW, Absalom AR. Neuronal damage biomarkers in the identification of patients at risk of long-term postoperative cognitive dysfunction after cardiac surgery. Anaesthesia. 2017;72(3):359-69.], 2017 |
Randomized clinical trial |
57 (CABG or OPCAB) |
(Serum brain fatty acid-binding protein) |
15 (26) in 3 months, and 13 (27) in 15 months |
Classical neuronal injury-related biomarkers had no prognostic value for POCD |
|
|
Silva et al.[2727 Silva FP, Schmidt AP, Valentin LS, Pinto KO, Zeferino SP, Oses JP, et al. S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft surgery: a prospective observational study. Eur J Anaesthesiol. 2016;33(9):681-9.], 2016 |
Prospective observational study |
88/0 |
(Serum S100β and NSE) |
23 (26.1) at 21 days, and 20 (22.7) in 6 months |
Serum S100B was more accurate than NSE in the detection of POCD |
|
|
ÖztÜrk et al.[2828 Öztürk S, Saçar M, Baltalarli A, Öztürk I. Effect of the type of cardiopulmonary bypass pump flow on postoperative cognitive function in patients undergoing isolated coronary artery surgery. Anatol J Cardiol. 2016;16(11):875-80.], 2016 |
Prospective, randomized, double-blind study |
40/0 |
Pulsatile vs. nonpulsatile flow (Serum 100β and NSE) |
3 (15) vs. 3 (15) on POD3 |
No difference between types of pump flow for POCD |
|
|
Oldham et al.[2929 Oldham MA, Hawkins KA, Yuh DD, Dewar ML, Darr UM, Lysyy T, et al. Cognitive and functional status predictors of delirium and delirium severity after coronary artery bypass graft surgery: an interim analysis of the Neuropsychiatric Outcomes After Heart Surgery study. Int Psychogeriatr. 2015;27(12):1929-38.], 2015 |
Prospective observational cohort study |
102/0 |
|
14 (14) on POD2 through discharge |
Cognitive and functional impairment independently predicted postoperative delirium and delirium severity |
|
Preoperative cognitive and functional impairment |
Hassani et al.[3030 Hassani S, Alipour A, Darvishi Khezri H, Firouzian A, Emami Zeydi A, Gholipour Baradari A, et al. Can Valeriana officinalis root extract prevent early postoperative cognitive dysfunction after CABG surgery? A randomized, double-blind, placebo-controlled trial. Psychopharmacology (Berl). 2015;232(5):843-50.], 2015 |
Randomized, double-blind, placebo-controlled trial |
61/0 |
Valerian capsule (containing 530 mg of valerian root extract/capsule) (1,060 mg/day) vs. placebo capsule each 12 h for 8 weeks |
Valerian prophylaxis: reduced odds of POCD in comparison to placebo on POD10 and in 2 months |
|
Valerian capsule |
|
Dong et al.[3131 Dong S, Li CL, Liang WD, Chen MH, Bi YT, Li XW. Postoperative plasma copeptin levels independently predict delirium and cognitive dysfunction after coronary artery bypass graft surgery. Peptides. 2014;59:70-4.], 2014 |
Prospective cohort study |
108/0 |
(Plasma copeptin) |
35 (32.4) on POD7 |
Postoperative plasma copeptin level may be a useful predictor of POCD |
|
|
Trubnikova et al.[3232 Trubnikova OA, Mamontova AS, Syrova ID, Maleva OV, Barbarash OL. Does preoperative mild cognitive impairment predict postoperative cognitive dysfunction after on-pump coronary bypass surgery? J Alzheimers Dis. 2014;42(Suppl 3):S45-51.], 2014 |
Case-control study |
101/0 |
MCI vs. non-MCI |
36 (72) vs. 40 (79) at early stage (P=0.5), and 36 (72) vs. 35 (70) in 1 year (P=0.8) |
MCI was not a leading cause of early or long-term POCD |
|
|
Kok et al.[3333 Kok WF, van Harten AE, Koene BM, Mariani MA, Koerts J, Tucha O, et al. A pilot study of cerebral tissue oxygenation and postoperative cognitive dysfunction among patients undergoing coronary artery bypass grafting randomised to surgery with or without cardiopulmonary bypass. Anaesthesia. 2014;69(6):613-22.], 2014 |
Randomized pilot study |
29/30 |
CABG vs. OPCAB (Cerebral oximetry variable) |
11 (39) vs. 4 (14) at early stage (P=0.50), and 4 (14) vs. 0 (0) at 3 months (P=0.03) |
There was no association between intraoperative cerebral oximetry variables and POCD at any stage |
OPCAB |
CABG |
Szwed et al.[3434 Szwed K, Pawliszak W, Anisimowicz L, Bucinski A, Borkowska A. Short-term outcome of attention and executive functions from aorta no-touch and traditional off-pump coronary artery bypass surgery. World J Biol Psychiatry. 2014;15(5):397-403.], 2014 |
Prospective observational single-surgeon trial |
0/74 |
"No-touch" OPCAB vs. "traditional" OPCAB |
10 (28.6) vs. 20 (51.3) on POD7 (discharge) |
|
"No touch" OPCAB |
|
Fontes et al.[3535 Fontes MT, McDonagh DL, Phillips-Bute B, Welsby IJ, Podgoreanu MV, Fontes ML, et al; Neurologic Outcome Research Group (NORG) of the Duke Heart Center. Arterial hyperoxia during cardiopulmonary bypass and postoperative cognitive dysfunction. J Cardiothorac Vasc Anesth. 2014;28(3):462-6.], 2014 |
Retrospective study |
118/0 (CABG or CABG + valve surgery with CPB) |
Arterial hyperoxia during CPB |
53 (45) at 6 weeks |
Arterial hyperoxia during CPB was not associated with neurocognitive decline after 6 weeks |
|
|
Sirvinskas et al.[3636 Sirvinskas E, Usas E, Mankute A, Raliene L, Jakuska P, Lenkutis T, et al. Effects of intraoperative external head cooling on short-term cognitive function in patients after coronary artery bypass graft surgery. Perfusion. 2014;29(2):124-9.], 2014 |
Prospective study |
50/0 |
Head-cooling vs. no head-cooling |
9 (36) vs. 16 (64) on POD10 (P=0.048) |
|
Head-cooling technique during the aortic cross-clamp |
|
Joung et al.[377 Rundshagen I. Postoperative cognitive dysfunction. Dtsch Arztebl Int. 2014;111(8):119-25.], 2013 |
Randomized pilot study |
0/70 |
rIPC vs. control |
10 (28.6) vs. 11 (31.4) on POD7 (P=0.794) |
rIPC did not reduce the incidence of POCD |
|
|
Mu et al.[3838 Mu DL, Li LH, Wang DX, Li N, Shan GJ, Li J, et al. High postoperative serum cortisol level is associated with increased risk of cognitive dysfunction early after coronary artery bypass graft surgery: a prospective cohort study. PLoS One. 2013;8(10):e77637.], 2013 |
Prospective cohort study |
166/0 |
(Serum cortisol) |
66 (39.8) on POD7 |
|
|
High serum cortisol level on POD1 |
Kadoi et al.[3939 Kadoi Y, Kawauchi C, Kuroda M, Takahashi K, Saito S, Fujita N, et al. Association between cerebrovascular carbon dioxide reactivity and postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus. J Anesth. 2011;25(5):641-7.], 2011 |
Prospective study |
124/0 |
Normal vs. medium vs. impaired cerebrovascular CO2 reactivity |
20 (30) vs. 10 (25) vs. 11 (57) on POD7, and 16 (24) vs. 9 (23) vs. 5 (26) at 6 months |
|
|
Impaired cerebrovascular CO2 reactivity |
de Tournay-Jettéet al.[4040 de Tournay-Jetté E, Dupuis G, Bherer L, Deschamps A, Cartier R, Denault A. The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth. 2011;25(1):95-104.], 2011 |
Prospective study |
61 (CABG or OPCAB) |
(rSO2) |
46 (80.7) on POD4-7, and 23 (38.3) in 1 month |
|
|
Intraoperative rSO2 desaturation |
Slater et al.[4141 Slater JP, Guarino T, Stack J, Vinod K, Bustami RT, Brown JM 3rd, et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg. 2009;87(1):36-44.], 2009 |
Prospective controlled study |
240/0 |
(rSO2 saturation) |
70 (29) in 3 months |
Patients with rSO2 desaturation score >3,000%-second had a significantly higher risk of POCD |
|
rSO2 desaturation score >3,000%-second |
Haljan et al.[4242 Haljan G, Maitland A, Buchan A, Arora RC, King M, Haigh J, et al. The erythropoietin neuroprotective effect: assessment in CABG surgery (TENPEAKS): a randomized, double-blind, placebo controlled, proof-of-concept clinical trial. Stroke. 2009;40(8):2769-75.], 2009 |
Prospective study |
32/0 |
Erythropoietin vs. placebo |
2 (8.3) vs. 3 (38) in 2 months (P=0.085) |
|
Erythropoietin |
|
Silbert et al.[4343 Silbert BS, Evered LA, Scott DA, Cowie TF. The apolipoprotein E epsilon4 allele is not associated with cognitive dysfunction in cardiac surgery. Ann Thorac Surg. 2008;86(3):841-7.], 2008 |
Prospective study |
282/0 |
(Apolipoprotein genotype) |
33 (12) in 3 months, and 31 (11) in 12 months |
There was no relationship between presence of the apolipoprotein epsilon4 allele or any of the six genotypes and POCD |
|
|
Jensen et al.[4444 Jensen BØ, Rasmussen LS, Steinbrüchel DA. Cognitive outcomes in elderly high-risk patients 1 year after off-pump versus on-pump coronary artery bypass grafting. A randomized trial. Eur J Cardiothorac Surg. 2008;34(5):1016-21.], 2008 |
Prospective randomized study |
47/43 |
CABG vs. OPCAB |
4 (9) vs. 8 (19) in 12 months (P=0.18) |
No significant differences in the incidence of POCD between CABG and OPCAB group |
|
|
Hogue et al.[4545 Hogue CW, Fucetola R, Hershey T, Freedland K, Dávila-Román VG, Goate AM, et al. Risk factors for neurocognitive dysfunction after cardiac surgery in postmenopausal women. Ann Thorac Surg. 2008;86(2):511-6.], 2008 |
Prospective study |
113/0 (CABG/CABG+ valve operation) |
(Apolipoprotein epsilon4 genotype) |
28 (25) in 4-6 weeks |
Mild atherosclerosis of the ascending aorta, CPB time, aortic cross-clamping time and length of hospitalization, but not apolipoprotein epsilon4 genotype were risks for POCD |
|
|
Puskas et al.[4646 Puskas F, Grocott HP, White WD, Mathew JP, Newman MF, Bar-Yosef S. Intraoperative hyperglycemia and cognitive decline after CABG. Ann Thorac Surg. 2007;84(5):1467-73.], 2007 |
Prospective study |
525/0 |
Hyperglycemic vs. nonhyperglycemic |
157 (40) vs. 38 (29) at 6 weeks (P=0.017) |
|
|
Intraoperative hyperglycemia |
Kadoi and Goto[4747 Kadoi Y, Goto F. Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery. J Anesth. 2007;21(3):330-5.], 2007 |
Prospective study |
106/0 |
Sevoflurane vs. non-sevoflurane |
13 (22) vs. 11 (23) in 6 months |
Sevoflurane did not have any significant effects on POCD |
|
|
Kadoi and Goto[4848 Kadoi Y, Goto F. Factors associated with postoperative cognitive dysfunction in patients undergoing cardiac surgery. Surg Today. 2006;36(12):1053-7.], 2006 |
Prospective study |
88/0 |
|
24 (27.3) in 6 months |
Age, diabetes mellitus and renal failure were associated with POCD at 6 months |
|
|
Jensen et al.[4949 Jensen BO, Hughes P, Rasmussen LS, Pedersen PU, Steinbrüchel DA. Cognitive outcomes in elderly high-risk patients after off-pump versus conventional coronary artery bypass grafting: a randomized trial. Circulation. 2006;113(24):2790-5.], 2006 |
Prospective randomized study |
51/54 |
OPCAB vs. CABG |
4 (7.4) vs. 5 (9.8) in 3 months (P=0.7) |
No significant difference in the incidence of POCD between OPCAB and CABG |
|
|
Silbert et al.[5050 Silbert BS, Scott DA, Evered LA, Lewis MS, Kalpokas M, Maruff P, et al. A comparison of the effect of high- and low-dose fentanyl on the incidence of postoperative cognitive dysfunction after coronary artery bypass surgery in the elderly. Anesthesiology. 2006;104(6):1137-45.], 2006 |
Prospective randomized study |
326/0 |
High-dose fentanyl vs. low-dose fentanyl |
22 (13.7) vs. 40 (23.6) in 1 week (P=0.03) |
|
High-dose fentanyl |
Low-dose fentanyl |
Wang et al.[5151 Wang D, Wu X, Li J, Xiao F, Liu X, Meng M. The effect of lidocaine on early postoperative cognitive dysfunction after coronary artery bypass surgery. Anesth Analg. 2002;95(5):1134-41.], 2002 |
Prospective randomized study |
88/0 |
Lidocaine vs. placebo |
8 (18.6) vs. 18 (40.0) at early stage (?) (P=0.028) |
|
Intraoperative administration of lidocaine |
|