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

The Association of Infection with Delirium in the Post-Operative Period after Elective CABG Surgery DOI Open Access
Agnieszka Żukowska, Mariusz Kaczmarczyk, Mariusz Listewnik

et al.

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(14), P. 4736 - 4736

Published: July 17, 2023

Delirium is one of the most common complications coronary artery by-pass graft (CABG) surgery. The identification patients at increased risk delirium and implementation preventive measures to reduce postoperative necessary improve treatment outcomes after CABG. aim this study was assess association between infection 10-year mortality in undergoing CABG This a retrospective, observational cohort planned on-pump April 2010 December 2012. We analysed group 3098 operated on our cardiac surgery centre, from whom we selected All were assessed for infection, such as pneumonia, bloodstream infections (BSIs) surgical site (SSIs). Patients who experienced significantly more likely have (7.4% vs. 22%; p = 0.0037). As regards particular types significant differences only found pneumonia sternal SSIs. had lower 5-year (p 0.0136) 0.0134) survival. Postoperative increases long-term Pneumonia SSIs increase patients.

Language: Английский

Citations

4
Sex Differences in Delirium after Coronary Artery Bypass Graft Surgery and Perioperative Neuropsychiatric Conditions: A Secondary Analysis of a Cohort Study DOI
Mark Oldham,

Bennett Kukla,

Patrick Walsh

et al.

Journal of Geriatric Psychiatry and Neurology, Journal Year: 2024, Volume and Issue: 37(6), P. 473 - 481

Published: April 11, 2024

Biological sex influences the risk of depression and cognitive impairment, but its role in relation to postoperative delirium is unclear. This analysis investigates differences after coronary artery bypass graft (CABG) surgery sex-related affective symptoms.

Language: Английский

Citations

1
Bedeutung von psychosozialen Faktoren in der Kardiologie – Update 2024 DOI
Ingrid Kindermann,

Volker Köllner,

Christian Albus

et al.

Deleted Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 4, 2024

Citations

1
The effectiveness of postoperative delirium prevention, diagnosis, and intervention protocol in patients monitored in the intensive care unit after cardiac surgery: a quasi-experimental study DOI Creative Commons
Gönül Kara Söylemez, Hülya Bulut

BMC Nursing, Journal Year: 2024, Volume and Issue: 23(1)

Published: Dec. 18, 2024

The incidence of delirium is high in the intensive care unit (ICU) after cardiac surgery. development evidence-based protocols for management and training nurses this regard can ensure effective delirium. This quasi-experimental study aimed to assess effectiveness a postoperative prevention, diagnosis, intervention protocol patients undergoing monitoring ICU included 64 who underwent surgery met inclusion criteria, along with 14 working ICU. Patients were divided into control (n = 32) groups. comprised three phases: determining group diagnosis status nurses; providing on protocol; implementing preliminary finally, group. Statistical significance was set at p < 0.05. While there no significant agreement between researcher (kappa: 0.207) (p > 0.05), observed 1.00) 0.001). rate 14.3% 100% group, which difference. 21.9% 9.4% although difference not significant. Postoperative effectively enhance compliance among researchers improve accuracy postcardiac patients. implementation recommended such retrospectively registered Clinicaltrials.gov 19.02.2024 (Clinical Trials ID: NCT06268119).

Language: Английский

Citations

1
Effect of preoperative sleep disorders on delirium in proximal femoral surgery patients aged 60 or older DOI Creative Commons

Fuyi Han,

Xiaojie Liu, Hui Huang

et al.

BMC Anesthesiology, Journal Year: 2023, Volume and Issue: 23(1)

Published: Nov. 17, 2023

Abstract Objective To examine the effect of preoperative sleep disorders on delirium in patients older than 60 years age who underwent surgery for proximal femoral fracture. Methods This is a prospective observational study. We prospectively selected 143 with fracture between April 2021 and 2022. The primary outcome was postoperative (PD). Multiple logistic regression analyses were performed receiver operating characteristic (ROC) curve generated. quality all eligible participants assessed through Pittsburgh Sleep Quality Index (PSQI). Confusion Assessment Method (CAM) used to assess PD from first seventh day postoperatively. Patients divided into two groups according diagnosis: (1) no (NPD) group (2) (PD) group. Results Of patients, 43 (30.1%) diagnosed PD. analysis demonstrated that ICU admissions (OR = 2.801, p 0.049) 1.477 < 0.001) independently associated A PSQI score predictive (AUC 0.808, 95% CI 0.724 ~ 0.892, 0.001). Conclusion Preoperative sleeping may be an independent risk factor leading development aged or older.

Language: Английский

Citations

3
Pre-Habilitation of Cardiac Surgical Patients, Part 2: Frailty, Malnutrition, Respiratory disease, Alcohol/Smoking cessation and Depression DOI
Harikesh Subramanian, Joshua Knight, Ibrahim Sultan

et al.

Seminars in Cardiothoracic and Vascular Anesthesia, Journal Year: 2022, Volume and Issue: 26(4), P. 295 - 303

Published: Oct. 2, 2022

The concept of “pre-habilitation” comprises screening for and identification pre-existing disorders followed by medical optimization. This is performed many types surgeries, but may have profound impacts on outcomes, particularly in cardiac surgery given the multiple comorbidities typically carried these patients. Components pre-habilitation include direct intervention preoperative specialists as well significant care coordination shared decision-making. In this second part a two-part review, authors describe existing evidence to support optimization various problems present few institutional protocols utilized at out center presurgical care. installment will focus alcohol smoking cessation management frailty, malnutrition, respiratory disease, depression.

Language: Английский

Citations

5
Controversies in enhanced recovery after cardiac surgery DOI Creative Commons
Andrew Shaw, Nicole R. Guinn, Jessica Brown

et al.

Perioperative Medicine, Journal Year: 2022, Volume and Issue: 11(1)

Published: April 27, 2022

Advances in cardiac surgical operative techniques and myocardial protection have dramatically improved outcomes the past two decades. An unfortunate unintended consequence is that 80% of preventable morbidity mortality following surgery now originates outside operating room. Our hope a renewed emphasis on evidence-based best practice standardized perioperative care will reduce overall improve patient-centric care. The Perioperative Quality Initiative (POQI) Enhanced Recovery After Surgery-Cardiac Society (ERAS® Cardiac) identified significant evidence gaps medicine related to surgery, defined as areas which there controversy about how manage patients. These five focus include patient blood management, goal-directed therapy, acute kidney injury, opioid analgesic reduction, delirium.

Language: Английский

Citations

4
The 10 Commandments of ERAS for Cardiac Surgery DOI Open Access
Vicki Morton-Bailey, Rawn Salenger, Daniel T. Engelman

et al.

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery, Journal Year: 2021, Volume and Issue: 16(6), P. 493 - 497

Published: Nov. 1, 2021

Language: Английский

Citations

5
Incidence and Associated Factors of Postoperative Delirium in Adults Undergoing Cardiac Surgery With Cardiopulmonary Bypass: A Prospective Cohort Study DOI Open Access

Yating Guo,

Chengyang Li,

Yan Mu

et al.

Journal of Clinical Nursing, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 9, 2024

Delirium is one of the most common and serious complications after cardiac surgery with cardiopulmonary bypass (CPB). A comprehensive assessment independent risk factors for postoperative delirium (POD) essential early detection prevention. To investigate incidence associated POD in adults undergoing CPB. Prospective cohort design. total 203 patients were enrolled this study from October 2022 to December 2023 China. Richmond agitation sedation scale (RASS) confusion method-intensive care unit (CAM-ICU) used assessing symptom. This analysed various POD, including demographic, physical, psychological, social, spiritual environmental aspects. Using logistic regression analysis identify factors. totla 60.1% (n = 122) had POD. Of these cases, 86 (70.5%) hypoactive delirium, 4 (3.3%) hyperactive 32 (26.2%) mixed delirium. Advanced age (OR 1.069, 95% confidence interval [CI]: 1.031-1.107; p < 0.001), preoperative depression 1.847, CI: 1.246-2.736; 0.002), albumin level 0.921, 0.851-0.997; 0.042) duration mechanical ventilation > 1.000, 1.000-1.001; 0.001) predictors The CPB was high. identified advanced age, depression, as significant study's findings highlight urgent necessity improved clinical vigilance proactive management strategies. No patient or public contribution.

Language: Английский

Citations

0
Cardiac Psychology: Psychosocial and Behavioral Assessment and Treatment for Cardiovascular Conditions DOI
Alyssa Vela, Allison J. Carroll

Journal of Health Service Psychology, Journal Year: 2023, Volume and Issue: 49(1), P. 21 - 32

Published: Feb. 1, 2023

Language: Английский

Citations

1