Reynolds JD, Amory DW, Grocott HP, White WD, Newman MF. Change in plasma glutamate concentration during cardiac surgery is a poor predictor of cognitive outcome.
J Cardiothorac Vasc Anesth 2002;
16:431-6. [PMID:
12154420 DOI:
10.1053/jcan.2002.125148]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE
To develop a simple and reliable method for quantitating plasma glutamate concentration and apply this method to monitor systemic glutamate levels during coronary artery bypass graft (CABG) surgery, a procedure associated with neurologic deficits.
DESIGN
Prospective serial investigation of cardiac surgery patients.
SETTING
Tertiary-care university teaching hospital.
PARTICIPANTS
Patients undergoing CABG surgery (n = 33).
INTERVENTIONS
Preoperative and postoperative neurologic and neurocognitive testing were done. Intraoperative blood samples for glutamate quantitation were obtained from jugular bulb and pulmonary artery catheters before, during, and after cardiopulmonary bypass.
MEASUREMENTS AND MAIN RESULTS
Glutamate concentrations were determined using a reverse-phase high-pressure liquid chromatography method coupled to precolumn derivatization of the analyte with o-phthalaldehyde. The mean prebypass plasma glutamate concentration was 79.4 +/- 41.8 micromol/L. Plasma glutamate levels fluctuated during surgery with considerable degrees of temporal and quantitative interpatient variability. Neurologic and neurocognitive deficits were observed after CABG surgery. However, neither the occurrence nor the severity of cognitive decline could be predicted by the magnitude of increase in plasma glutamate concentration.
CONCLUSION
Fluctuations in intraoperative systemic glutamate levels do not predict post-CABG surgery neurologic outcome.
Collapse