MIAO Jianxia,CHEN Lei,CHEN Feifei, et al. Effect of Shenmai injection on changes of patients’ cognitive function after received cardiopulmonary bypass[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(5): 338-.
Abstract： Objective: To observe the changes of patient’s cognitive function after undergoing cardiac valve replacement with cardiopulmonary bypass (CPB) and the intervention effect of Shenmai injection (SMI). Methods: Forty United States Association of Anesthesiologists (ASA) II or III patients (New York Heart Association, NYHA II or III) of the Mini-Mental State Examination (MMSE, range 0～30) scores≥26 after undergoing cardiac valve replacement with CPB were randomly divided into SMI group (group S, n=20) and control group (group C, n=20). After anesthesia induction, the patients of group S were infused intravenously with SMI (0.6 mL/kg added to 250 mL normal saline), and the patients of group C were given with equivalent normal saline at the same time, both completed before CPB. Aortic clamped time, CPB time, duration of anesthesia were recorded. Heart rate (HR), mean arterial pressure (MAP), jugular venous oxygen saturation (SJvO2) and jugular venous oxygen partial pressure (PJvO2) of anesthesia induction (T0), 10 min after induction (T1), CPB re-warmed to 36 ℃(T2), and 1 h (T3), 6 h (T4) , 24 h (T5), 48 h (T6), 72 h (T7) after CPB were recorded. MMSE were performed three days after surgery and the incidence of POCD was recorded. Results: There was no statistical significance in aortic clamped time, duration of CPB, anesthesia time, and hemodynamics (P>0.05) between the two of groups. Compared with T0, SJvO2 and PJvO2 of group C from T1 to T2, T4 to T7 and group S at T1, T4 to T7 decreased (P<0.05, P<0.01). Compared with group C, SJvO2 and PJvO2 of group S at T2 and T3 increased (P<0.01). MMSE evaluation and the incidence of POCD of group S were better than those of group C three days after surgery (P<0.05, P<0.01). Conclusion: Cardiac valve replacement with CPB can lead to cognitive impairment in patients and Shenmai injection can improve cognitive function by increasing oxygen supply for brain tissue.
