Pseudocholinesterase-Activity Reduction during Cardiopulmonary Bypass

Rump, A.F.E.; Schierholz, Jörg Michael; Biederbick, W.; Theisohn, M.; Diefenbach, C.; Abel, Manfred; Börner, U.; Buzello, W.; Klaus, W.

doi:10.1016/s0306-3623(98)00072-x

Cited by 10 publications

(1 citation statement)

References 13 publications

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“…Intraoperative drug administration was standardized and not adapted for this study. It has been previously verified that the applied pharmacological agents do not inhibit cholinergic activity at therapeutic serum concentrations [ 53 , 54 ]. Furthermore, we considered the medication regime in the ICU as not adjustable.…”

Section: Discussionmentioning

confidence: 99%

Potentials of Acetylcholinesterase and Butyrylcholinesterase Alterations in On-Pump Coronary Artery Bypass Surgery in Postoperative Delirium: An Observational Trial

Zajonz,

Kunzemann,

Schreiner

et al. 2023

JCM

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Cardiac surgery is regularly associated with postoperative delirium (POD), affected by neuro-inflammation and changes in cholinergic activity. Therefore, this prospective observational study aimed to evaluate whether pre- and perioperative changes in blood acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activity were associated with POD development in patients undergoing isolated elective coronary artery bypass graft (CABG) surgery. It included 93 patients. Pre- and postoperative blood AChE and BChE activities were measured with photometric rapid-point-of-care-testing. The Intensive Care Delirium Screening Checklist and the Confusion Assessment Method for the Intensive Care Unit were used to screen patients for POD. POD developed in 20 patients (21.5%), who were older (p = 0.003), had higher EuroSCOREs (p ≤ 0.001), and had longer intensive care unit stays (p < 0.001). On postoperative day one, BChE activity decreased from preoperative values more in patients with (31.9%) than without (23.7%) POD (group difference p = 0.002). Applying a cutoff of ≥32.0% for BChE activity changes, receiver operating characteristic analysis demonstrated a moderate prediction capability for POD (area under the curve = 0.72, p = 0.002). The risk of developing POD was 4.31 times higher with a BChE activity change of ≥32.0% (p = 0.010). Monitoring the pre- to postoperative reduction in BChE activity might be a clinically practicable biomarker for detecting patients at risk of developing POD after CABG surgery.

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Section: Discussionmentioning

confidence: 99%