Delirium in cardiac surgery - risk factors and prevention DOI Open Access

Mihaela Preveden,

Andrej Preveden, Ranko Zdravković

et al.

Medicinski pregled, Journal Year: 2022, Volume and Issue: 75(3-4), P. 133 - 137

Published: Jan. 1, 2022

Introduction. Delirium is defined as an acute change in mental status that leads to disturbance perception, thinking, memory, attention, emotional status, well sleep rhythm disorders and most often reversible. Postoperative delirium disorder develops after cardiovascular surgery with incidence of 20 - 50% operated patients. This complication associated a longer hospitalization, stay the intensive care unit, increased morbidity mortality. Risk Factors. The risk factors are divided into preoperative, intraoperative postoperative. common preoperative older age, stenosis carotid arteries, previous cerebral diseases, depression, diabetes, hypertension, low ejection fraction left ventricle, heart disorders. Intraoperative include type surgery, anesthesia, duration extracorporeal circulation, aortic clamp. important postoperative use psychoactive drugs, prolonged pain, opioid mechanical ventilation, length unit. Prevention. Prevention very aspect focused on precipitating factors. Preventive treatment includes pharmacological non-pharmacological methods. main recommendation refers avoiding routine antipsychotics. Conclusion. Continuous infusion dexmedetomidine compared propofol reduces delirium. Nonpharmacological approach consists series procedures carried out postoperatively, such protocol monitoring Awakening, Breathing, Coordination, Delirium, Early mobility, Family engagement.

Language: Английский

Perioperative near infrared spectroscopy measurements of cerebral regional oxygen desaturations are not associated with delirium after cardiac surgery DOI

Ronald A. Kahn,

Natalia Egorova,

Yuxia Ouyang

et al.

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

Citations

1
Preinterventional frailty assessment in patients scheduled for cardiac surgery or transcatheter aortic valve implantation: a consensus statement of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC) DOI Open Access
Josef Niebauer, Caroline Bäck, Heike A. Bischoff‐Ferrari

et al.

European Journal of Preventive Cardiology, Journal Year: 2023, Volume and Issue: 31(2), P. 146 - 181

Published: Oct. 7, 2023

Language: Английский

Citations

14
Perioperative Risk Factors for Postoperative Cognitive Dysfunction after Cardiac Valve Replacement: A Retrospective Case-Control Study DOI

宗笑 李

Advances in Clinical Medicine, Journal Year: 2025, Volume and Issue: 15(04), P. 2370 - 2381

Published: Jan. 1, 2025

Language: Английский

Citations

0
Perioperative dexmedetomidine for the prevention of postoperative delirium after cardiac surgery: a systematic review, Bayesian meta-analysis, and Bayesian re-analysis of the DECADE trial DOI

T K Hunt,

Thomas Payne, James M. Brophy

et al.

British Journal of Anaesthesia, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

Language: Английский

Citations

0
Preinterventional frailty assessment in patients scheduled for cardiac surgery or transcatheter aortic valve implantation: a consensus statement of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC) DOI Open Access
Simon Sündermann, Caroline Bäck, Heike A. Bischoff‐Ferrari

et al.

European Journal of Cardio-Thoracic Surgery, Journal Year: 2023, Volume and Issue: 64(4)

Published: Oct. 1, 2023

prediction tool for early mortality after cardiac surgery .

Language: Английский

Citations

10
Comprehensive characterization of the postoperative pericardial inflammatory response: Potential implications for clinical outcomes DOI Creative Commons
Ali Fatehi Hassanabad, Friederike I. Schoettler, William Kent

et al.

JTCVS Open, Journal Year: 2022, Volume and Issue: 12, P. 118 - 136

Published: Sept. 27, 2022

There is a paucity of data on the inflammatory response that takes place in pericardial space after cardiac surgery. This study provides comprehensive assessment local postoperative response.Forty-three patients underwent cardiotomy, where native fluid was aspirated and compared with effluent collected at 4, 24, 48 hours' postcardiopulmonary bypass. Flow cytometry used to define levels proportions specific immune cells. Samples were also probed for concentrations cytokines, matrix metalloproteinases (MMPs), tissue inhibitors (TIMPs).Preoperatively, mainly contains macrophages T However, postsurgical populated predominately by neutrophils, which constituted almost 80% cells present, peaked 24 hours. When surgical approaches compared, minimally invasive surgery associated fewer neutrophils 4 postsurgery. Analysis intrapericardial mediators showed interleukin-6, MMP-9, TIMP-1 be highest Over time, MMP-9 decreased significantly, whereas increased, resulting significant reduction ratio MMP:TIMP surgery, suggesting active processes may influence extracellular remodeling.These results show elicits profound alterations cell profile space. Defining cellular molecular drive pericardial-specific allow targeted therapies reduce immune-mediated complications.

Language: Английский

Citations

15
Timing, Threshold, and Duration of Intraoperative Hypotension in Cardiac Surgery: Their Associations With Postoperative Delirium DOI Creative Commons

Masahiro Ushio,

Moritoki Egi, Daichi Fujimoto

et al.

Journal of Cardiothoracic and Vascular Anesthesia, Journal Year: 2022, Volume and Issue: 36(11), P. 4062 - 4069

Published: June 19, 2022

Language: Английский

Citations

14
Melatonin and Its Analogs for Prevention of Post-cardiac Surgery Delirium: A Systematic Review and Meta-Analysis DOI Creative Commons
Yunyang Han, Yu Tian, Jie Wu

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2022, Volume and Issue: 9

Published: May 18, 2022

Background The effectiveness of melatonin and its analogs in preventing postoperative delirium (POD) following cardiac surgery is controversial. purpose this systematic review meta-analysis was to confirm the benefits on prevention adults who underwent surgery. Methods We systematically searched PubMed, Cochrane Library, Web Science, Embase, EBSCOhost databases, last search performed October 2021 repeated before publication. controlled studies were included if investigated impact POD primary outcome incidence delirium. Stata statistical software 17.0 used perform study. Results This eight randomized trials (RCTs) two cohort with a total 1,714 patients. results showed that ramelteon administration associated significantly lower (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.29–0.74; P = 0.001). subgroup analyses confirmed 3 mg (OR, 0.37; CI, 0.18–0.76; 0.007) 5 0.34; 0.21–0.56; < 0.001) reduced POD. Conclusion Melatonin at dosages considerably decreased risk surgery, according our results. Cautious interpretation important owing modest number heterogeneity among them. Systematic Review Registration PROSPERO registration number: CRD42021246984.

Language: Английский

Citations

12
Effectiveness of Peer-Based and Conventional Video Education in Reducing Perioperative Depression and Anxiety Among Coronary Artery Bypass Grafting Patients: A Randomized Controlled Trial DOI

Shadan Pedramrazi,

Ali Mohammadabadi, Zahra Rooddehghan

et al.

Journal of PeriAnesthesia Nursing, Journal Year: 2024, Volume and Issue: 39(5), P. 741 - 749

Published: Feb. 27, 2024

Language: Английский

Citations

2
Risk factors of delirium after cardiac surgery: a systematic review and meta-analysis DOI Creative Commons
Yue Wang,

Bingjie Wang

Journal of Cardiothoracic Surgery, Journal Year: 2024, Volume and Issue: 19(1)

Published: Dec. 20, 2024

Post-operative delirium (POD) is a relatively common occurrence following surgical procedures, particularly cardiac surgeries. Given that the majority of pharmacologic treatments for have demonstrated inadequate efficacy, it great importance to identify risk factors prevent or reduce its complications. Consequently, in this systematic review and meta-analysis, we identified POD after surgery. A comprehensive search literature was conducted using databases Scopus, PubMed, Web Science from inception April 22, 2024. The objective prospective cohorts had assessed associated with patients undergoing surgery multivariate regression. Of 3,166 studies were initially screened, 23 included review. Nine evaluated including age (OR 1.06, 95% CI (1.04, 1.08), p < 0.001), pre-operative depression 3.71, (2.45, 5.62), post-operative atrial fibrillation (AF) 2.39, (1.79, 3.21), hypertension (HTN) 1.64, (0.75, 3.56), = 0.212), ≥ 65 3.32, (2.40, 4.60), AF 4.43, (2.56, 7.69), diabetes mellitus 2.16, (1.39, 3.35), combined coronary artery bypass graft (CABG) + valve 2.73, (1.66, 4.49), cardiopulmonary (CPB) time 1.02, (1.01, 1.04), 0.001). total nine evaluated, which eight found statistically significant effect on developing POD. These can be employed more effectively at-risk Furthermore, approach facilitate earlier diagnosis effective patient care.

Language: Английский

Citations

2