Combined therapy with Medotilin/Elfunat for the prevention and treatment of neuropsychiatric complications after open-heart surgery

After open-heart surgery, postoperative neuropsychiatric complications often develop: stroke — in 4.8 % of cases, diffuse encephalopathy — in 12 %, behavior changes — in 5–40 %, cognitive impairment — in 12–79 %, mental disorders — in 13–64 %. The causes of their development are acetylcholine deficiency with subsequent dysfunction of the cholinergic system and oxidative stress, which result from hypoxia, hypoperfusion, and a systemic inflammatory reaction. In this regard, the appointment of drugs that restore the acetylcholine synthesis – choline alfoscerate (Medotilin), and drugs that suppress oxidative stress – mexidol (Elfunate) is considered a promising direction for the prevention and treatment of neuropsychiatric complications. The study conducted on the basis of the regional cardiac surgery center of the Odessa Regional Hospital demonstrated that the combined use of Medotilin and Elfunate can reduce the frequency of neuropsychiatric complications, as well as reduce the duration of treatment in the hospital.