Neurologic Complications in Cardiac Surgery. Is it Predictable

Despite all the progress observed in cardiac surgery in the last decades that have had an influence on the overall decrease of morbid-mortality, neurologic adverse effects presently represent a very important subject. After five decades since the first described reports of cardiopulmonary bypass (CPB), an enormous amount of medical information has been published about this method and the possible adverse effects or complications. As we mentioned adverse cerebral outcome is one of the principal causes of the length of stay and cost of hospitalization after cardiac surgery [1]. The question, based on the available medical information is “Would neurologic undesirable effects be minimized or even predictable during cardiac surgery?” Our aim in this lecture is to review these points and in a didactic meaning focus on cardiac surgery with CPB as an incidence of the nervous system morbidity, its classification according to morbid neurologic outcomes, the risk and mechanisms of neurological injury associated with the surgical procedure and, finally, the intraoperative management that may interfere with reducing cerebral events.