Mattimore Daniel, Fischl Adrian, Christophides Alexa, Cuenca Jerry, Davidson Steven, Jin Zhaosheng, Bergese Sergio
Department of Anesthesiology, Stony Brook University Hospital, Stony Brook, NY 11794, USA.
Brain Sci. 2023 Dec 7;13(12):1682. doi: 10.3390/brainsci13121682.
Postoperative delirium (POD) after cardiac surgery is a well-known phenomenon which carries a higher risk of morbidity and mortality. Multiple patient-specific risk factors and pathophysiologic mechanisms have been identified and therapies have been proposed to mitigate risk of delirium development postoperatively. Notably, cardiac surgery frequently involves the use of an intraoperative cardiopulmonary bypass (CPB), which may contribute to the mechanisms responsible for POD. Despite our greater understanding of these causative factors, a substantial reduction in the incidence of POD remains high among cardiac surgical patients. Multiple therapeutic interventions have been implemented intraoperatively and postoperatively, many with conflicting results. This review article will highlight the incidence and impact of POD in cardiac surgical patients. It will describe some of the primary risk factors associated with POD, as well as anesthetic management and therapies postoperatively that may help to reduce delirium.
心脏手术后的术后谵妄（POD）是一种众所周知的现象，它具有更高的发病和死亡风险。已经确定了多种患者特异性风险因素和病理生理机制，并提出了治疗方法以降低术后谵妄发生的风险。值得注意的是，心脏手术经常涉及术中使用体外循环（CPB），这可能有助于导致POD的机制。尽管我们对这些致病因素有了更深入的了解，但心脏手术患者中POD的发生率仍然很高。术中及术后已经实施了多种治疗干预措施，许多结果相互矛盾。这篇综述文章将重点介绍POD在心脏手术患者中的发生率和影响。它将描述一些与POD相关的主要风险因素，以及术后可能有助于减少谵妄的麻醉管理和治疗方法。
