The Design and Methodology of Clinical Studies of Neuroprotection in Cardiac Surgery

Despite years of intensive investigation and research, cerebral injury following cardiac surgery remains a major cause of postoperative morbidity and has been associated with as much as a 10% increase in hospital mortality, increased length of stay, and expensive rehabilitation.1 The clinical manifestations of neurological impairment include almost all the possible deficits and modalities of dysfunction depending on the nature and localization (single or multiple) of the injury,2 with the spectrum of deficits ranging from subtle changes in cognitive function to overt stroke.3 The cognitive deficits after cardiac surgery are similar to those occurring with aging: attention, concentration, memory, and speed of response are the most affected areas.4