Der einfluss von pentoxifyllin auf kognitive dysfunktion und befindlichkeit nach offener koronarrevaskularisation unter einsatz der herz-lungen-maschine

In a prospective randomized placebo-controlled double-blind study involving 43 male patients (nPlacebo= 24; nPTX=19) we examined the effect of pentoxifylline (PTX) on cognitive dysfunction and mood state after open coronary revascularisation. PTX (5mg/kg) or NaCl 0.9% was given as a single bolus intra-operatively before cardiopulmonary bypass. Cognitive performance was determined using a standard German test of attention ("Zahlen-Verbindungs- Test", ZVT), and current mood state using a multidimensional self-assessment inventory (BSKE (EWL)), at three different time points (prior to and 48 and 96 hours after surgery). The concentration of the neuron-specific enolase (NSE), a marker protein for brain damage, was measured at five time points. 48 hours after surgery, the PTX group needed significantly less time to complete the ZVT than the control group (30.9 ± 4.5 sec vs. 41.9 ± 20.1 sec; p=0.018). Analysis of the mood state expressed by the subtest levels "depression" and "anxiety" revealed significant differences, with better values scored by the PTX-group. For the subtest level "apathy" and "physical discomfort" group differences closely approached significance. With regard to the NSE-concentrations no differences were found between the groups. We conclude that the cognitive dysfunction and mood disorders that regularly occur after coronary bypass-operations can be reduced by the application of PTX.