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Although the technique of \u2018off\u2010pump\u2019 coronary revascularisation may potentially be associated with improved outcome, long\u2010term follow\u2010up studies have failed to demonstrate a significant reduction in the incidence of postoperative cognitive dysfunction. The focus of research is thus shifting from cardiopulmonary bypass to other factors common to both techniques, such as surgery, anaesthesia and patient\u2010related predisposing factors. Priming of the immune system by ageing and atherosclerosis may result in an exaggerated systemic and cerebral inflammatory response to cardiac surgery and anaesthesia, causing neuronal loss or dysfunction resulting in cognitive dysfunction. We briefly discuss the evidence for cardiopulmonary bypass\u2010related neuronal injuries in adult cardiac surgery patients, and review the evidence that immune priming is a key factor in the pathogenesis of cognitive dysfunction after cardiac surgery.<\/jats:p>","DOI":"10.1111\/j.1365-2044.2011.07008.x","type":"journal-article","created":{"date-parts":[[2012,2,9]],"date-time":"2012-02-09T14:42:16Z","timestamp":1328798536000},"page":"280-293","source":"Crossref","is-referenced-by-count":230,"title":["A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia"],"prefix":"10.1111","volume":"67","author":[{"given":"A. E.","family":"van Harten","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. W. L.","family":"Scheeren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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