Journal of Cardiothoracic Surgery,
Год журнала:
2024,
Номер
19(1)
Опубликована: Авг. 1, 2024
Abstract
Background
Postoperative
delirium
(POD),
an
acute
and
variable
disturbance
in
cognitive
function,
is
intricate
elusive
phenomenon
that
occurs
after
cardiac
surgery.
Despite
progress
surgical
techniques
perioperative
management,
POD
remains
a
formidable
challenge,
imposing
significant
burden
on
patients,
caregivers,
healthcare
systems.
Methods
This
prospective
observational
study
involved
307
patients
who
underwent
Data
the
occurrence
of
delirium,
clinical
parameters,
postoperative
characteristics
were
collected.
A
multivariate
analysis
was
performed
to
assess
relationship
between
POH
POD.
Results
Sixty-one
(21%)
developed
with
average
onset
approximately
5
days
postoperatively
duration
6
days.
On
analysis,
significantly
associated
POD,
adjusted
odds
ratios
indicated
more
likely
develop
(OR,
5.61;
p
=
0.006).
Advanced
age
1.11;
0.002),
emergency
surgery
8.31;
0.001),
on-pump
coronary
artery
bypass
grafting
identified
as
risk
factors
Patients
typically
older,
be
male,
had
higher
morbidity
rates
than
those
did
not.
Conclusion
critically
ill
Surgical
complexity
advanced
contribute
developing
poor
outcomes.
Brazilian Journal of Anesthesiology (English Edition),
Год журнала:
2024,
Номер
unknown, С. 844560 - 844560
Опубликована: Сен. 1, 2024
Postoperative
Delirium
(POD)
is
a
common,
transient
postoperative
cognitive
dysfunction
in
elderly
patients.
The
relationship
between
POD
and
intraoperative
hypotension
remains
unclear.
This
study
aims
to
determine
if
predicts
male
patients
undergoing
laryngectomy.
Diagnostics,
Год журнала:
2023,
Номер
13(13), С. 2290 - 2290
Опубликована: Июль 6, 2023
Despite
the
acceptance
of
carotid
ultrasound
for
predicting
patients’
fluid
responsiveness
in
critical
care
and
anesthesia,
its
efficacy
hypotension
remains
unclear
perioperative
setting.
Electronic
databases
were
searched
from
inception
to
May
2023
identify
observational
studies
focusing
on
use
corrected
blood
flow
time
(FTc)
respirophasic
variation
artery
peak
velocity
(ΔVpeak)
assessing
risks
responsiveness.
Using
FTc
as
a
predictive
tool
(four
studies),
analysis
yielded
pooled
sensitivity
0.82
(95%
confidence
interval
(CI):
0.72
0.89)
specificity
0.94
CI:
0.88
0.97)
risk
(area
under
curve
(AUC):
0.95).
For
responsiveness,
0.79
0.84)
0.81
0.75
0.86),
respectively
(AUC:
0.87).
In
contrast,
ΔVpeak
predict
showed
0.76
0.63
0.85)
0.74
0.66
0.8)
0.79).
The
current
meta-analysis
provides
robust
evidence
supporting
high
diagnostic
accuracy
which
requires
further
verification.
Journal of Clinical Anesthesia,
Год журнала:
2023,
Номер
93, С. 111343 - 111343
Опубликована: Ноя. 22, 2023
Postoperative
delirium
(POD)
is
a
serious
complication
of
surgery,
especially
in
the
elderly
patient
population.
It
has
been
proposed
that
decreasing
amount
anesthetics
by
titrating
to
an
EEG
index
will
lower
POD
rate,
but
clear
evidence
missing.
A
strong
age-dependent
negative
correlation
reported
between
peak
oscillatory
frequency
alpha
waves
and
end-tidal
anesthetic
concentration,
with
older
patients
generating
slower
frequencies.
We
hypothesized,
oscillations
are
associated
higher
rate
POD.
Research Square (Research Square),
Год журнала:
2024,
Номер
unknown
Опубликована: Фев. 2, 2024
Abstract
Background:
Post-induction
hypotension
(PIH)
increases
surgical
complications
including
myocardial
injury,
acute
kidney
delirium,
stroke,
prolonged
hospitalization,
and
endangerment
of
the
patient's
life.
Machine
learning
is
an
effective
tool
to
analyze
large
amounts
data
identify
perioperative
complication
factors.
This
study
aims
risk
factors
for
PIH
develop
predictive
models
support
anesthesia
management.
Methods:
A
dataset
5406
patients
was
analyzed
using
machine
methods.
Logistic
regression,
random
forest,
XGBoost,
neural
network
were
compared.
Model
performance
evaluated
area
under
receiver
operating
characteristic
curve
(AUROC),
calibration
curves,
decision
analysis
(DCA).
Results:
The
logistic
regression
model
achieved
highest
AUROC
0.74
(95%
CI,
0.71
-
0.77),
indicating
good
discrimination.
Calibration
curves
demonstrated
satisfactory
forest
models.
DCA
revealed
that
had
clinical
benefit.
showed
best
in
predicting
selected
as
final
model.
Baseline
blood
pressure,
age,
sex,
type
surgery,
platelet
count,
certain
anesthesia-inducing
drugs
identified
important
features.
Conclusions:
provides
a
valuable
personalized
preoperative
assessment
customized
management,
allowing
early
intervention
improved
patient
outcomes.
Integration
into
electronic
medical
record
systems
can
facilitate
real-time
prediction.
Frontiers in Neurology,
Год журнала:
2024,
Номер
15
Опубликована: Июль 17, 2024
Observational
research
suggests
that
hypotension
is
a
potential
hazard
factor
of
delirium.
Nevertheless,
previous
observational
articles
are
limited
in
their
ability
to
establish
causality
between
and
The
present
study
was
sought
explore
the
genetic
causal
relationship
these
two
conditions
using
two-sample
Mendelian
randomization
(MR).
PLoS ONE,
Год журнала:
2024,
Номер
19(11), С. e0312966 - e0312966
Опубликована: Ноя. 1, 2024
Associations
between
intraoperative
hypotension
(IOH)
and
various
postoperative
outcomes
were
shown
in
retrospective
trials
using
a
variety
of
different
definitions
IOH.
This
complicates
the
comparability
these
makes
clinical
application
difficult.
Information
about
best
performing
IOH
regarding
30-day
mortality,
hospital
length
stay
(hLOS),
postanesthesia
care
unit
(PACU-LOS)
is
missing.
Diagnostics,
Год журнала:
2023,
Номер
13(17), С. 2819 - 2819
Опубликована: Авг. 31, 2023
The
use
of
ultrasonography
to
predict
spinal-induced
hypotension
(SIH)
has
gained
significant
attention.
This
diagnostic
meta-analysis
aimed
investigate
the
reliability
inferior
vena
cava
collapsibility
index
(IVCCI)
in
predicting
SIH
patients
undergoing
various
surgeries.
Databases,
including
Embase,
Cochrane
Library,
Medline,
and
Google
Scholar,
were
screened
until
28
July
2023,
yielding
12
studies
with
1076
(age
range:
25.6–79
years)
cesarean
section
(CS)
(n
=
4)
or
non-CS
surgeries
8).
Patients
had
a
significantly
higher
IVCCI
than
those
without
(mean
difference:
11.12%,
95%
confidence
interval
(CI):
7.83–14.41).
pooled
incidence
rate
was
40.5%.
demonstrated
satisfactory
overall
(sensitivity,
77%;
specificity,
82%).
area
under
curve
(AUC)
0.85,
indicating
its
high
capability
differentiate
at
risk
PSH.
Fagan
nomogram
plot
positive
likelihood
ratio
(PLR)
4
negative
(NLR)
0.28.
results
underscore
robustness
discriminative
ability
as
predictive
tool
for
SIH.
Nevertheless,
future
investigations
should
focus
on
assessing
applicability
high-risk
exploring
potential
enhancement
patient
safety
through
incorporation
into
clinical
practice.
Journal of Cardiothoracic Surgery,
Год журнала:
2024,
Номер
19(1)
Опубликована: Окт. 17, 2024
This
study
explores
the
factors
contributing
to
occurrence
of
delirium
following
cardiac
surgery
and
devises
nursing
strategies
rooted
in
behavior
change
theory.