Mariscalco Giovanni, Mariani Silvia, Biancari Fausto, Banach Maciej
Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, United Kingdom.
Division of Cardiac Surgery, University of Oulu,Oulu, Finland.
Psychiatr Pol. 2015;49(6):1359-70. doi: 10.12740/PP/60139.
Delirium is a common complication after cardiac surgery, being associated with significant mortality and morbidity. The pathogenesis of postoperative delirium (POD) is complex and multifactorial, involving an interaction of multiple predisposing and precipitating factors. There are several hypothesis regarding the underlying mechanisms of POD, and the most recent emerging one involves neuroinflammation, which is exacerbated by the cardiopulmonary bypass-induced systemic inflammatory response. Experimental and clinical studies have recently documented improved perioperative central neural protection exerted by statins because of their anti-inflammatory, immunomodulatory, and antithrombotic properties. The present review will focused on the possible protective effect exerted by preoperative statin administration on delirium following cardiac surgery.
谵妄是心脏手术后常见的并发症,与显著的死亡率和发病率相关。术后谵妄(POD)的发病机制复杂且多因素,涉及多种易感因素和促发因素的相互作用。关于POD潜在机制有几种假说,最近出现的一种涉及神经炎症,体外循环诱导的全身炎症反应会使其加剧。实验和临床研究最近记录了他汀类药物因其抗炎、免疫调节和抗血栓特性而在围手术期发挥的改善中枢神经保护作用。本综述将聚焦于术前给予他汀类药物对心脏手术后谵妄可能产生的保护作用。