Transcranial Doppler to predict thinking problems after coronary artery bypass
Can Transcranial Doppler Predict Postoperative Cognitive Dysfunction After Cardiopulmonary Bypass
This project will test whether measuring middle cerebral artery blood flow with transcranial Doppler during cardiopulmonary bypass can help predict postoperative delirium or cognitive problems in adults having elective CABG.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 106 (estimated) |
| Ages | 18 Years to 70 Years |
| Sex | All |
| Sponsor | Bakirkoy Dr. Sadi Konuk Research and Training Hospital Government |
| Locations | 1 site (Istanbul) |
| Trial ID | NCT07000461 on ClinicalTrials.gov |
What this trial studies
This single-center, prospective observational study will enroll 65 adults aged 18–70 scheduled for isolated elective CABG at Bakırköy Dr. Sadi Konuk Training and Research Hospital. Investigators will measure middle cerebral artery flow with transcranial Doppler during cardiopulmonary bypass and record whether bypass flow is pulsatile or non-pulsatile, alongside standard monitoring including NIRS cerebral oximetry and preoperative MMSE. Outcomes include postoperative cognitive dysfunction and delirium, with predefined exclusions for carotid stenosis ≥50%, prior cerebrovascular events, low EF, poor temporal windows, or prolonged postoperative ventilation. Data will be analyzed to see if intraoperative MCA flow patterns predict cognitive outcomes and whether pulsatile flow relates to fewer neurologic events.
Who should consider this trial
Good fit: Adults 18–70 scheduled for isolated elective CABG with EF ≥40%, a preoperative MMSE score ≥23, an adequate temporal window for transcranial Doppler, and who can give informed consent are ideal candidates.
Not a fit: Patients with carotid stenosis ≥50%, prior stroke, EF <40%, failed temporal acoustic windows, emergency or reoperation cases, or those requiring prolonged ventilation or reintubation are excluded and unlikely to benefit from participation.
Why it matters
Potential benefit: If successful, this approach could help identify patients at higher risk for postoperative cognitive dysfunction and guide intraoperative perfusion strategies to reduce delirium and cognitive decline.
How similar studies have performed: Some prior work has shown physiologic benefits of pulsatile CPB for renal function and recovery, but evidence that pulsatile flow reduces postoperative cognitive dysfunction is limited, so using TCD to predict POCD during CPB is relatively novel.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients aged 18-70 * Patients scheduled for isolated elective cardiopulmonary bypass surgery Exclusion Criteria: * Patients with carotid stenosis ≥50% * Emergency patients or those with a history of reoperation * Patients with a history of cerebrovascular events * Patients who do not provide consent * Patients with temporal window failure * Patients with an ejection fraction (EF) \<40% * Patients with a Mini-Mental State Examination (MMSE) score \<23 * Patients who require mechanical ventilation for more than 24 hours or those who are reintubated
Where this trial is running
Istanbul
- Bakirkoy Dr. Sadi Konuk Research and Training Hospital — Istanbul, Turkey (Türkiye) (Recruiting)
Study contacts
- Study coordinator: Sema Nur Baki, M.D
- Email: sema.akcelik@gmail.com
- Phone: +905069443789
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.