Reduction of cognitive performance by piracetam in patients undergoing coronary bypass surgery using heart-lung maschine
- Publisher: Freie Universität Berlin Universitätsbibliothek, Garystr. 39, 14195 Berlin
610 Medizin und Gesundheit | 610 Medical sciences; Medicine | coronary | piracetam | cognitive dysfunction | surgery
Introduction: The occurrence of cognitive dysfunction after coronary bypass surgery poses a relevant clinical problem. The precise pathophysiological mechanisms underlying post-operative cognitive dysfunction remain to be fully elucidated. However, it seems safe to assume that the etiology is multifactorial. Piracetam is approved for the treatment of chronic cognitive dysfunction in dementia. Emerging data suggests that piracetam may also be beneficial for post-operative cognitive outcomes. This study was designed to test the hypothesis that intra-operative administration of 12 mg piracetam during aorto-coronary bypass (ACB) surgery improves post-operative neuro-psychological functioning.
Methods: A prospective double-blind randomized clinical study was conducted. Subtests of the "Syndrom-Kurz-Test" (SKT) as well as a subtest of the "Alzheimer’s Disease Assessment Scale" (ADAS) were used to study cognitive functioning preoperatively and on the third postoperative day.
Results: Cognitive functioning deteriorated after ACB. However, the magnitude of cognitive decline was significantly reduced in the piracetam as compared to the placebo group (0.71 vs. 1.32, p<0,0005 ).
Conclusion: Intraoperative piracetam may offer a promising new approach to reduce post-operative cognitive dysfunction after ACB. Multicentric prospective studies and studies with longer observational periods will have to confirm the results of this study.