Early postoperative cognitive decline—are there any preventive strategies for surgical patients in the emergency setting? DOI Open Access

Ana-Maria Cotae,

Liliana Mirea, Cristian Cobilinschi

и другие.

Signa Vitae, Год журнала: 2024, Номер unknown

Опубликована: Янв. 1, 2024

Postoperative neurocognitive impairments following surgery are a growing concern, especially in the elderly population, since it is associated with significantly increased risk of morbi-mortality postoperative period. Among them, delirium or early cognitive decline further prolonged dysfunction and may quicken long-term impairment (POCD). The current knowledge regarding preventive strategies for not focused anymore only on pharmacological behavioral management period, but also supports preoperative training programs. Since evaluation proactive interventions to optimize surgical patient outcomes rather impossible emergency setting, what appropriate that can be implemented day-to-day practice? In this review, we try highlight most recent experimental clinical strategies, outline relevant recommendations clinicial practicioners based available data.

Язык: Английский

Effects of Electrical Stimulation of the Cell: Wound Healing, Cell Proliferation, Apoptosis, and Signal Transduction DOI Creative Commons
Kazuo Katoh

Medical Sciences, Год журнала: 2023, Номер 11(1), С. 11 - 11

Опубликована: Янв. 17, 2023

Electrical stimulation of the cell can have a number different effects depending on type being stimulated. In general, electrical cause to become more active, increase its metabolism, and change gene expression. For example, if is low intensity short duration, it may simply depolarize. However, high or long hyperpolarized. The cells process by which an current applied in order their function behavior. This be used treat various medical conditions has been shown effective studies. this perspective, are summarized.

Язык: Английский

Процитировано

39

Effect of Dexmedetomidine on Cardiopulmonary Bypass Induced Inflammatory Response in Patients Undergoing Aortic Valve Replacement DOI Creative Commons
Zrinka Šafarić Oremuš, Nikola Bradić,

Ivan Gospic

и другие.

Life, Год журнала: 2025, Номер 15(4), С. 524 - 524

Опубликована: Март 22, 2025

Surgical aortic valve replacement (SAVR) remains an essential treatment option for patients with stenosis (AS). Open-heart surgery requires the use of cardiopulmonary bypass (CPB), which triggers inflammatory response that can lead to end-organ dysfunction and severe complications. Dexmedetomidine, a highly selective α2-adrenergic agonist, is widely used in anesthesia intensive care medicine its sedative, analgesic, sympatholytic properties. This study aimed investigate whether dexmedetomidine exerts clinically relevant anti-inflammatory effect undergoing open-heart determine optimal dose. A prospective, double-blind, placebo-controlled was conducted, including 60 randomized into three groups according Inflammatory markers (IL-6, TNF-α), renal function, other clinical parameters were analyzed at multiple time points. Statistical analyses performed assess differences between groups. Dexmedetomidine administration significantly affected TNF-α levels 12 h after CPB (p = 0.033), while previously reported suppression IL-6 not observed. associated lower opioid consumption before extubation showed tendency reduce postoperative delirium. Diuresis increased on first day dexmedetomidine-treated 0.003), no significant changes parameters. The incidence atrial fibrillation highest control group lowest high-dose group, though this difference statistically significant. These results suggest influences outcomes; however, further research needed confirm long-term benefits dosing strategies.

Язык: Английский

Процитировано

1

An Update on Postoperative Cognitive Dysfunction Following Cardiac Surgery DOI Creative Commons
T. Robert Vu, Julian A. Smith

Frontiers in Psychiatry, Год журнала: 2022, Номер 13

Опубликована: Июнь 15, 2022

Postoperative cognitive dysfunction is extremely prevalent following cardiac surgery. The increasing patient age and comorbidity profile increases their susceptibility to impairment. underlying pathophysiological mechanisms leading impairment are not clearly elucidated. Using the contemporary literature (2015–present), this narrative review has three aims. Firstly, provide an overview of postoperative Secondly, analyse predominant surgery such as inflammation, cerebral hypoperfusion, microemboli, glycaemic control anaesthesia induced neurotoxicity. Lastly, assess current therapeutic strategies interest address these mechanisms, including administration dexamethasone, prevention prolonged desaturations monitoring perfusion using near-infrared spectroscopy, surgical management reduce neurological effects intraoperative strategies, effect volatile vs. intravenous anaesthesia, efficacy dexmedetomidine.

Язык: Английский

Процитировано

30

The Role of miRNAs in Dexmedetomidine’s Neuroprotective Effects against Brain Disorders DOI Open Access
Codrin-Constantin Burlacu, Maria Adriana Neag, Andrei-Otto Mitre

и другие.

International Journal of Molecular Sciences, Год журнала: 2022, Номер 23(10), С. 5452 - 5452

Опубликована: Май 13, 2022

There are limited neuroprotective strategies for various central nervous system conditions in which fast and sustained management is essential. Neuroprotection-based therapeutics have become an intensively researched topic the neuroscience field, with multiple novel promising agents, from natural products to mesenchymal stem cells, homing peptides, nanoparticles-mediated all aiming significantly provide neuroprotection experimental clinical studies. Dexmedetomidine (DEX), α2 agonist commonly used as anesthetic adjuvant sedation opioid-sparing medication, stands out this context due its well-established effects. Emerging evidence preclinical studies suggested that DEX could be protect against cerebral ischemia, traumatic brain injury (TBI), spinal cord injury, neurodegenerative diseases, postoperative cognitive disorders. MicroRNAs (miRNAs) regulate gene expression at a post-transcriptional level, inhibiting translation of mRNA into functional proteins. In vivo vitro deciphered brain-related miRNAs dysregulated miRNA profiles after several disorders, including TBI, ischemic stroke, Alzheimer's disease, sclerosis, providing emerging new perspectives therapy by modulating these miRNAs. Experimental revealed some effects mediated miRNAs, counteracting mechanisms disease models, such lipopolysaccharides induced neuroinflammation, β-amyloid dysfunction, ischemic-reperfusion anesthesia-induced neurotoxicity models. This review aims outline disorders We address targeting ameliorating anesthetics, reducing improving diseases.

Язык: Английский

Процитировано

26

Dexmedetomidine alleviates cerebral ischemia-reperfusion injury via inhibiting autophagy through PI3K/Akt/mTOR pathway DOI
Jianli Li, Keyan Wang, Meinv Liu

и другие.

Journal of Molecular Histology, Год журнала: 2023, Номер 54(3), С. 173 - 181

Опубликована: Апрель 26, 2023

Язык: Английский

Процитировано

13

Anesthesia, the developing brain, and dexmedetomidine for neuroprotection DOI Creative Commons

Alexandra Tsivitis,

Ashley Wang,

Jasper Murphy

и другие.

Frontiers in Neurology, Год журнала: 2023, Номер 14

Опубликована: Июнь 7, 2023

Anesthesia-induced neurotoxicity is a set of unfavorable adverse effects on central or peripheral nervous systems associated with administration anesthesia. Several animal model studies from the early 2000’s, rodents to non-human primates, have shown that general anesthetics cause neuroapoptosis and impairment in neurodevelopment. It has been difficult translate this evidence clinical practice. However, some suggest lasting behavioral humans due anesthesia exposure. Dexmedetomidine sedative analgesic agonist activities alpha-2 (ɑ 2 ) adrenoceptors as well imidazoline type (I2) receptors, allowing it affect intracellular signaling modulate cellular processes. In addition being easily delivered, distributed, eliminated body, dexmedetomidine stands out for its ability offer neuroprotection against apoptosis, ischemia, inflammation while preserving neuroplasticity, demonstrated through many studies. This property puts unique position an anesthetic may circumvent potentially

Язык: Английский

Процитировано

13

Dexmedetomidine improves oxygen-glucose deprivation/reoxygenation (OGD/R) -induced neurological injury through regulating SNHG11/miR-324-3p/VEGFA axis DOI Open Access
Yujie Chen,

Zhiying Fan,

Qingwei Wu

и другие.

Bioengineered, Год журнала: 2021, Номер 12(1), С. 4794 - 4804

Опубликована: Янв. 1, 2021

Dexmedetomidine (Dex) has been reported to exhibit neuroprotective effects through various regulatory mechanisms. This study aims investigate the role and molecular mechanism of SNHG11 in Dex-mediated neuroprotection. The ischemic stroke (IS) model was established vivo by middle cerebral artery occlusion (MCAO) vitro oxygen-glucose deprivation reperfusion (OGD/R)-treated SH-SY5Y. highly expressed after OGD/R, Dex improved OGD/R-induced neurological injury. Additionally, reversed on Furthermore, we found that upregulated vascular endothelial growth factor A (VEGFA) expression targeting miR-324-3p. Through rescue assays, it confirmed regulated injury increasing VEGFA expression. At last, also discovered improve regulating rat model. In conclusion, our work demonstrated via SNHG11/miR-324-3p/VEGFA axis. These findings may offer a novel therapeutic strategy for IS treatment.

Язык: Английский

Процитировано

26

Dexmedetomidine alleviates olfactory cognitive dysfunction by promoting neurogenesis in the subventricular zone of hypoxic-ischemic neonatal rats DOI Creative Commons
Andi Chen, Xiaohong Chen,

Jianhui Deng

и другие.

Frontiers in Pharmacology, Год журнала: 2022, Номер 13

Опубликована: Авг. 19, 2022

Background: Hypoxic-ischemic brain damage (HIBD) is the main cause of neurological dysfunction in neonates. Olfactory cognitive function important for feeding, ability to detect hazardous situations and social relationships. However, only a few studies have investigated olfactory neonates with HIBD; furthermore, specific mechanisms involved are yet be elucidated. It has been reported that neurogenesis subventricular zone (SVZ) linked function. Recently, dexmedetomidine (DEX) shown provide neuroprotection following HIBD. In present study, we whether DEX could improve neonatal rats HIBD attempted determine underlying mechanisms. Methods: We induced using Rice–Vannucci model, (25 μg/kg, i.p.) was administered immediately after induction Next, used triphenyl tetrazolium chloride (TTC) staining Zea-longa score assess success modelling. The levels BDNF, TNF-α, IL-1β IL-6 were determined by western blotting. Immunofluorescence microglial activation M1/M2 polarization as well evaluate extent SVZ. To function, each group raised until post-natal days 28–35; then, performed buried food test memory test. Results: Analysis showed significant infarction, deficits, dysfunction. Furthermore, found treatment significantly improved rat pups also increased number newly formed neuroblasts (BrdU/DCX) neurons (BrdU/NeuN) SVZ increasing expression BDNF analysis neurogenic effects possibly related inhibition inflammation promotion M1 M2 conversion microglia. Conclusion: Based on findings, promoting enhancing possible associated inhibited neuroinflammation promoted

Язык: Английский

Процитировано

17

Dexmedetomidine nasal administration improves perioperative sleep quality and neurocognitive deficits in elderly patients undergoing general anesthesia DOI Creative Commons

Jiang He,

Xinning Zhang, Cuicui Li

и другие.

BMC Anesthesiology, Год журнала: 2024, Номер 24(1)

Опубликована: Янв. 30, 2024

Abstract Objective To investigate the improvement of perioperative sleep quality and neurocognitive impairment in elderly patients under general anesthesia by nasal administration dexmedetomidine. Methods One hundred twenty admitted to our hospital for various laparoscopic elective gynecological surgeries lasting more than 1 h from July 2021 March 2023 were selected. All subjects divided into 3 groups according random number table method. From 21:00 21:30 every night one day before 5 days after surgery, group A was given alprazolam 0.4 mg orally; B dexmedetomidine 1.5ug/kg drip; C saline drip. observed information, quality, postoperative cognitive function, anxiety status, adverse effects complication occurrence. Results The difference information between three not statistically significant, P > 0.05; scores on admission 0.05. At Preoperative 1d, 3d 5d, RCSQ higher those C, with as time increased; assessment status 1d surgery function significant preoperative (24.63 ± 2.23), (25.83 2.53), 5d (26.15 2.01) ( < 0.05), had better recovery increasing time; occurrence delirium (POD) (12.5%) lower (37.5%) (32.5%) 0.05). There no statistical significance evaluation state first operation 3d, d overall incidence reactions complications 17.5% significantly that Conclusion Dexmedetomidine can effectively improve disorder patients, reduce damage their POD, complications, has sedative, anti-anxiety effects, a high drug safety, worthy clinical application promotion.

Язык: Английский

Процитировано

4

Management of alcohol withdrawal syndromes in general hospital settings DOI Open Access
Kristopher A. Kast,

S. Alex Sidelnik,

Shamim H. Nejad

и другие.

BMJ, Год журнала: 2025, Номер unknown, С. e080461 - e080461

Опубликована: Янв. 8, 2025

Abstract The covid-19 pandemic was associated with an unprecedented increase in alcohol consumption and morbidity, including hospitalizations for withdrawal. Clinicians based hospitals must be ready to identify, assess, risk-stratify, treat withdrawal evidence interventions. In this clinically focused review, we outline the epidemiology, pathophysiology, clinical manifestations, screening, assessment, treatment of general hospital population. We review summarize studies addressing drug syndromes inpatient populations, a focus on use benzodiazepine drugs, phenobarbital, antiseizure α-2 adrenergic drugs. Emerging areas interest include novel biomarkers, risk stratification instruments, alternative symptom severity scales, severe resistant protocol variations–including non-symptom-triggered benzodiazepine-sparing protocols. identify key research identification populations who will benefit from non-benzodiazepine strategies, more individualized approaches guide treatment, greater inclusion gender racial ethnic minorities future studies.

Язык: Английский

Процитировано

0