Postoperative Cognitive Dysfunction After Cardiac Surgery

Dunstan, David W.; Taha, Rame; Gauvin, Dominique; Othmen, Lamia Ben; Wang, Yan; Blaise, Gilbert

doi:10.1378/chest.128.5.3664

Cited by 151 publications

(104 citation statements)

References 68 publications

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“…Indeed, in one study, small doses of ketamine appeared to reduce the incidence of POCD following on-pump coronary artery bypass grafting, possibly via a beneficial effect on the pro-and anti-inflammatory systems [54]. This widespread inflammatory response to on-pump cardiac surgery was previously thought to be caused by activation of the immune system following contact between blood and artificial materials of the bypass circuit, and by ischaemia-reperfusion injuries of the heart, lungs and kidneys following CPB [55,56]. In the presence of blood-brain barrier injury or disruption, it follows that systemic inflammation induced by CPB might also cause cerebral inflammation.…”

Section: Inflammationmentioning

confidence: 99%

“…It is well known that ageing is associated with susceptibility to POCD [55]; age is a predicting factor for POCD, irrespective of the preceding type of surgery [9]. In humans, ageing without comorbidity is associated with low-grade systemic inflammatory activityplasma tumour necrosis factor-a and interleukin-6 levels are significantly higher in older than younger humans [92].…”

Section: Ageing As a Cause Of Primingmentioning

confidence: 99%

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A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia

Harten¹,

2012

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SummaryPostoperative cognitive dysfunction is receiving increasing attention, particularly as it mainly affects the (growing) elderly population. Until recently, cognitive deficits after cardiac surgery were thought to be caused by physiological disturbances associated with the cardiopulmonary bypass technique. Although the technique of 'off-pump' coronary revascularisation may potentially be associated with improved outcome, long-term follow-up studies have failed to demonstrate a significant reduction in the incidence of postoperative cognitive dysfunction. The focus of research is thus shifting from cardiopulmonary bypass to other factors common to both techniques, such as surgery, anaesthesia and patient-related predisposing factors. Priming of the immune system by ageing and atherosclerosis may result in an exaggerated systemic and cerebral inflammatory response to cardiac surgery and anaesthesia, causing neuronal loss or dysfunction resulting in cognitive dysfunction. We briefly discuss the evidence for cardiopulmonary bypass-related neuronal injuries in adult cardiac surgery patients, and review the evidence that immune priming is a key factor in the pathogenesis of cognitive dysfunction after cardiac surgery.

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Section: Inflammationmentioning

confidence: 99%

Section: Ageing As a Cause Of Primingmentioning

confidence: 99%

A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia

Harten¹,

2012

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“…To date, studies examining associations between surgery and delirium have investigated microemboli migration [149][150][151], hypoperfusion [64,137,[152][153][154], inflammatory responses [155][156][157], changes in hormone levels [158][159][160][161], and local and general anesthesia [64,133,162,163]. Gottesman and colleagues [152] hypothesized that a drop in the mean arterial pressure may put patients at risk for early cognitive dysfunction.…”

Section: Surgical Factors and Postoperative Cognitive Dysfunctionmentioning

confidence: 99%

Pathophysiology of Delirium in the Intensive Care Unit

Gunther

Morandi

Ely

2008

Critical Care Clinics

156

101

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“…It's considered a contrary event observed in elderly patients submitted to a cardiac surgery [1], being rare among youngster patients and others who submit to noncardiac surgeries [2]. Even though some researches show that local anesthesia can cause cognitive dysfunction, it is known that general anesthesia and its depth can lead to a higher percentage of POCD [3].…”

Section: Introductionmentioning

confidence: 99%

Effects of the Transcranial Direct Current Stimulation on Prevention of Postoperative Cognitive Dysfunction after Cardiac Surgery: Prospective, Randomized, Double-Blind Study

Valentin¹

2015

JNSK

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Introduction: Postoperative cognitive dysfunction (POCD) is a contrary event observed between 20 to 83%, especially in elderly and after cardiac surgery. Prevention and rehabilitation on cases of POCD may improve the quality of life. The neuromodulator effect of the noninvasive cerebral stimulation has been used in the treatment of brain injuries, depression, and also in the cognitive rehabilitation. The hypothesis is that the use of the transcranial direct current stimulation (tDCS) technique can decrease the occurrence of POCD and cognitively rehabilitate patients submitted to cardiac surgeries. The objective of this study will be to evaluate the tDCS effect over the occurrence of POCD in patients on cardiac surgeries.

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Postoperative Cognitive Dysfunction After Cardiac Surgery

Cited by 151 publications

References 68 publications

A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia

A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia

Pathophysiology of Delirium in the Intensive Care Unit

Effects of the Transcranial Direct Current Stimulation on Prevention of Postoperative Cognitive Dysfunction after Cardiac Surgery: Prospective, Randomized, Double-Blind Study

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