Change in plasma glutamate concentration during cardiac surgery is a poor predictor of cognitive outcome.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Reynolds, JD; Amory, DW; Grocott, HP; White, WD; Newman, MF

Published Date

  • August 2002

Published In

Volume / Issue

  • 16 / 4

Start / End Page

  • 431 - 436

PubMed ID

  • 12154420

Pubmed Central ID

  • 12154420

International Standard Serial Number (ISSN)

  • 1053-0770

Digital Object Identifier (DOI)

  • 10.1053/jcan.2002.125148

Language

  • eng

Conference Location

  • United States