The influence of artificial circulation on the development of postoperative cognitive dysfunction
There was investigated the influence of laminar and pulsating flow during artificial circulation on the development of cognitive dysfunction in case of operations by straight myocardial revasculization. Before operation 53, 5% of patients did not have any cognitive disorders, 46,5 % of patients had single or small cognitive disorders. After operation with laminar flow in the nearest postoperative period 27,3 % of patients did not have cognitive disorders, 72,7 % had single or small cognitive disorders. In case of artificial circulation with pulsating flow the cognitive dysfunction is present with 53,8 % of patients, no disorders are marked with 46,2 % of cases. The disorders of cognitive dysfunction are observed in the fields of attention, memory, visual-spatial and constructive praxes and, probably, connected with oxygen transport. During the perfusion with pulsating flow the indices of oxygen transport are in physiological limits, while with laminar flow the oxygen consumption and the coefficient of oxygen extraction are decreased, this proves the formation of arterio-venous shunt, disorders of oxygen delivery to tissues and prolonged oxygen debt.