Recurring neurological issue after CABG

[wiki88]

Hi Guys,

My dad underwent heart bypass surgery last Wednesday. He has 3 vessel disease with significant calcification, the possibility for angioplasty was ruled out. The plan was to go for beating heart surgery but once they opened him up, the surgeon decided to put him on a heart lung machine because his vessels were bone hard and it would have been next to impossible to place the grafts on a beating heart.

Apart from this, the surgery went well. The main problems started after the surgery, the doctors usually remove the ventilator 4-5 hours after surgery but in the case of my father, every time they would try to wean him off the ventilator, his vital signs would drop and they decided not to take him off the ventilator. This continued for a while and after 48 hours he was active enough (following vocal commands, coughing when he was asked to, nodding to answers asked off of him; he was still unable to visually focus on people though) to take him off the ventilator.

After taking him off the ventilator, his condition did not improve drastically, it remained somewhat similar for 6-8 hours and then it deteriorated to an extent that he was not following vocal commands any more and after about 25 hours off the ventilator he was put back on it due to respiratory distress.

He has been on a ventilator since then (96+ hours). For the last 30 hours, he has been in and out of consciousness, sometimes he would be "there" understanding basic questions, responding by sticking out his tongue, other times he just responds to voices by opening his eyes with random eye movements, not following any vocal commands and at other times he just doesn't respond even if he's grabbed by the shoulder and shaken lightly.

His CT scan was normal with no indication of bleeding or stroke, his urea/creatinine was normal before surgery (38/1.1; urea upto 50 normal creatinine upto 1.3 normal) shot up to 109/2.1 after the operation and then to 140/2.9 3 days ago. Since then it has improved to 150/2.4. His liver is barely ok (he was put on warfarin but had to be taken off it due to liver function deteriorating).

The doctors say that they do not think there is any significant damage to the brain and he is responsive some times, he just doesn't stay that way. His oxygenation levels are ok and so is heart function.

Right now they are confused by the way his brain is responding and have no idea when or if he will recover. They are planning to do an MRI but they don't think it'll tell them much. The doctor told me today that the neurons might take time to be ready or they may not recover at all.

What I do not understand is why does he cycle between these sort of extreme mental stages, is there and explanation for this? and has someone you know gone through a situation like this. Any help would be greatly appreciated.

If you people need any more info, please let me know.

[purple1234567]

I'm so sorry to hear about your father's condition- I'm not much help when it comes to the cause of this, but I do hope that he improves very soon- keep us updated on how he is doing!