Femoral Vein Pulsatility and Neurocognitive Disorder in Cardiac Surgery

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS CJC Open Pub Date : 2025-02-01 DOI:10.1016/j.cjco.2024.11.002

Ali Hammoud RN, MSc , Tanya Mailhot RN, PhD , Melissa Parent MD , Karel Huard MD , Olivier Lachance MD , Patrick Tawil MD , Alexander Calderone MD , Sylvie Levesque MSc , Stéphanie Jarry RN, MSc , William Beaubien-Souligny MD, PhD , Étienne J. Couture MD , André Y. Denault MD, PhD

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Abstract

Background

Neurocognitive disorder and venous congestion are related in cardiac surgery. Femoral vein (FV) Doppler allows noninvasive assessment of venous congestion. This study aims to associate postoperative neurocognitive disorder in cardiac surgery with FV pulsatility.

Method

A secondary analysis was conducted using data from retrospective and prospective cohorts. FV Doppler and neurocognitive disorder were measured upon admission to the intensive care unit (ICU) after surgery. An index of FV pulsatility of ≥ 50% was considered abnormal. The presence of neurocognitive disorder was assessed using the Intensive Care Delirium Score Checklist (ICDSC). Descriptive statistical analyses and logistic regression were used to test the association between FV Doppler pulsatility and neurocognitive disorder.

Results

A total of 273 patients from both cohorts were analyzed, 155 (57%) patients had FV pulsatility indexes ≥ 50%. Abnormal pulsatile Doppler was associated with the presence of neurocognitive disorder compared with normal FV Doppler profile (57 vs 43%, odds ratio [OR], 1.73; 95% confidence interval [CI], 1.06-2.81). FV pulsatility was also associated with age, higher rate of stroke, prolongation of intubation duration and a longer ICU stay.

Conclusions

FV pulsatility is associated with the presence of neurocognitive disorder and postoperative complications in cardiac surgery. The FV Doppler technique is simple and fast, offering the potential to anticipate complications related to venous congestion, such as delirium. Future multicentre studies with larger samples will be necessary to consolidate these findings.