Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Anaesthesia. 2018 Jan;73 Suppl 1:67-75. doi: 10.1111/anae.14142.
Brain injury from cardiac surgery is an important source of patient morbidity and mortality. The relationship between risk of brain injury and advanced age portends a rising frequency of these complications due to an increasing proportion of elderly patients undergoing cardiac surgery. This review will explore the aetiology and risk factors for peri-operative stroke, postoperative cognitive dysfunction and postoperative delirium. The prevention of each of these conditions will also be discussed, with a focus on brain protection strategies and the avoidance of cerebral embolism and hypoperfusion.
心脏手术引起的脑损伤是患者发病率和死亡率的一个重要来源。脑损伤风险与高龄之间的关系预示着由于接受心脏手术的老年患者比例不断增加,这些并发症的发生频率将会上升。本综述将探讨围手术期卒中、术后认知功能障碍和术后谵妄的病因和危险因素。还将讨论每种情况的预防措施,重点是脑保护策略以及避免脑栓塞和灌注不足。