General Anesthesia for Transcatheter Aortic Valve Replacement: Total Intravenous Anesthesia is Associated with Less Delirium as Compared to Volatile Agent Technique

Goins, Allie; Smeltz, Alan M.; Ramm, Cassandra J.; Strassle, Paula D.; Teeter, Emily G.; Vavalle, John P.; Kolarczyk, Lavinia

doi:10.1053/j.jvca.2017.12.018

Cited by 20 publications

(9 citation statements)

References 28 publications

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“…Contrary to our results, sevoflurane was found to increase delirium in a subset of postoperative patients when compared with midazolam. 10,11 However, immunomodulation and post-conditioning effects on the hypoxic brain may have influenced the development of delirium. 12,13 A robust explanation for our findings is that we extubated patients in the mTTM-36/sevo group earlier after ROSC, thus reducing the need for prolonged sedation.…”

Section: Discussionmentioning

confidence: 99%

A multimodal sevoflurane-based sedation regimen in combination with targeted temperature management in post-cardiac arrest patients reduces the incidence of delirium: An observational propensity score-matched study

et al. 2021

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Section: Discussionmentioning

confidence: 99%

A multimodal sevoflurane-based sedation regimen in combination with targeted temperature management in post-cardiac arrest patients reduces the incidence of delirium: An observational propensity score-matched study

et al. 2021

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“…We divided these factors into two groups, which are shown in the following tables with the items ordered according to their level of evidence and quality (John Hopkins Nursing Evidence-Based Practice [66]) according to the studies from which they were extracted. [19,29,40,44,80,88] Low level of education [4,9,28,58,67] Hypertension [75,80,87,88] Hypotension [14,16,23,76,81] High creatinine level [29,84,100] Immobilisation [30,32,75,91] Anaemia [44,70,81,83,91] Arterial fibrillation [17,26,44,83,90] Abnormally high albumin level [3,44,60,74,100] Cerebral aging [16,81,95] Functional deficit [29,78,…”

Section: Factors Associated With the Onset And Development Of Postoperative Deliriummentioning

confidence: 99%

“…Predisposing factors. ,14,16-19,24,26,30-32,38,40,42,44,45,47,49-51,53,54,58,59,61,67-109] Pre-existing cognitive deterioration [1,3,8,9,14,16,18,31,32,40,45,46,54,60,67,76,78-81,91,94,97,110-116] Pain [2,4,14,30-32,34,69-71,75,79,80,91,100,104,111,117-122] Elevated ASA score[14,19,31,38,40,42,48,49,75,84,88,118] Alcohol abuse[16,23,30,32,44,67,81,90,91,97,101,121] Hypoxemia[23,30,67,70,76,80,91] Male sex[14,18,32,39,49,51,58,87,88,101,103,122] Metabolic disturbances, Water-electrolyte imbalance[16,30,31,75,76,80,…”

mentioning

confidence: 99%

Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review

et al. 2021

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“Postoperative delirium” is defined as delirium occurring in the hospital up to one week after a procedure or before discharge (whichever occurs first) that meets the DSM-5 diagnostic criteria. Objectives: To describe the risk factors related to this pathology and identify effective non-pharmacological forms of treatment. An integrative review of the available literature was performed. The search results considered included all quantitative studies published between 2011 and 2019 in both English and Spanish. A total of 117 studies were selected. Advanced age was identified as the principal risk factor for postoperative delirium. Nursing interventions appear to be the key to preventing or reducing the seriousness of delirium after an anaesthetic episode. The aetiology of postoperative delirium remains unknown, and no treatment exists to eliminate this pathology. The role of nursing staff is fundamental in the prevention, diagnosis, and management of the pathology.

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“…There is no consistent evidence that any single anaesthetic agent or technique reduces the risk of postoperative cognitive dysfunction. In particular, there is no strong evidence that a propofol intravenous anaesthetic technique offers any advantages, although it may reduce delirium . Although it might be expected that regional anaesthesia would confer cognitive protection, once again evidence is lacking.…”

Section: Postoperative Cognitive Disordersmentioning

confidence: 99%

Peri‐operative optimisation of elderly and frail patients: a narrative review

Chan

Irwin

2019

Anaesthesia

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With increasing life expectancy and technological advancement, provision of anaesthesia for elderly patients has become a significant part of the overall case-load. These patients are unique, not only because they are older with more propensity for comorbidity but a decline in physiological reserve and cognitive function invariably accompanies ageing; this can substantially impact peri-operative outcome and quality of recovery. Furthermore, it is not only morbidity and mortality that matters; quality of life is also especially relevant in this vulnerable population. Comprehensive geriatric assessment is a patient-centred and multidisciplinary approach to peri-operative care. The assessment of frailty has a central role in the pre-operative evaluation of the elderly. Other essential domains include optimisation of nutritional status, assessment of baseline cognitive function and proper approach to patient counselling and the decision-making process. Anaesthetists should be proactive in multidisciplinary care to achieve better outcomes; they are integral to the process. Twitter: @mgirwin advanced age [2]. Although chronological age itself predicts surgical outcome poorly, age-related decline in physiological reserve and functional capacity are inevitable, and affect all organ systems. When people live longer, more comorbidities appear; this will result in higher rates of peri-operative morbidity and mortality. This is already imposing a significant burden on healthcare systems, by increasing both the utilisation of intensive care facilities and length of hospital stay [3,4]. Therefore, it is imperative to deliver both high-quality and efficient peri-operative care for elderly patients.The 'elderly' represent a unique group of patients, with many challenges for the peri-operative care team. In this article, we review the following aspects of anaesthesia in the elderly: (1) the role of comprehensive geriatric assessment and innovative models of care; (2) the implications of frailty and its assessment; (3) the assessment and optimisation of nutritional status; (4) the assessment of neurocognitive dysfunction; and (5) patient counselling and approach to decision-making. 80

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General Anesthesia for Transcatheter Aortic Valve Replacement: Total Intravenous Anesthesia is Associated with Less Delirium as Compared to Volatile Agent Technique

Cited by 20 publications

References 28 publications

A multimodal sevoflurane-based sedation regimen in combination with targeted temperature management in post-cardiac arrest patients reduces the incidence of delirium: An observational propensity score-matched study

A multimodal sevoflurane-based sedation regimen in combination with targeted temperature management in post-cardiac arrest patients reduces the incidence of delirium: An observational propensity score-matched study

Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review

Peri‐operative optimisation of elderly and frail patients: a narrative review

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