Juliana Norsham, Abd Aziz Nur Adilah Shuhada, Maluin Sofwatul Mokhtarah, Abu Yazit Noor Anisah, Azmani Sahar, Kadiman Suhaini, Hafidz Kamilah Muhammad, Mohd Fahmi Teng Nur Islami, Das Srijit
Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia, Nilai 71800, Negeri Sembilan, Malaysia.
Department of Anesthesia and Intensive Care, Institut Jantung Negara, Kuala Lumpur 50400, Malaysia.
J Clin Med. 2024 Jul 9;13(14):4015. doi: 10.3390/jcm13144015.
Nutritional status significantly influences cardiac surgery outcomes, with malnutrition contributing to poorer results and increased complications. This study addresses the critical gap in understanding by exploring the relationship between pre-operative nutritional status and post-operative cognitive dysfunction (POCD) in adult cardiac patients. : A comprehensive search across key databases investigates the prevalence of malnutrition in pre-operative cardiac surgery patients, its effects, and its association with POCD. Factors exacerbating malnutrition, such as chronic illnesses and reduced functionality, are considered. The study also examines the incidence of POCD, its primary association with CABG procedures, and the impact of malnutrition on complications like inflammation, pulmonary and cardiac failure, and renal injury. : Findings reveal that 46.4% of pre-operative cardiac surgery patients experience malnutrition, linked to chronic illnesses and reduced functionality. Malnutrition significantly contributes to inflammation and complications, including POCD, with an incidence ranging from 15 to 50%. CABG procedures are particularly associated with POCD, and malnutrition prolongs intensive care stays while increasing vulnerability to surgical stress. : The review underscores the crucial role of nutrition in recovery and advocates for a universally recognized nutrition assessment tool tailored to diverse cardiac surgery patients. Emphasizing pre-operative enhanced nutrition as a potential strategy to mitigate inflammation and improve cognitive function, the review highlights the need for integrating nutrition screening into clinical practice to optimize outcomes for high-risk cardiac surgery patients. However, to date, most data came from observational studies; hence, there is a need for future interventional studies to test the hypothesis that pre-operative enhanced nutrition can mitigate inflammation and improve cognitive function in this patient population.
营养状况对心脏手术结果有显著影响，营养不良会导致更差的结果和更多的并发症。本研究通过探索成年心脏患者术前营养状况与术后认知功能障碍（POCD）之间的关系，填补了认识上的关键空白。：在关键数据库中进行全面检索，调查术前心脏手术患者中营养不良的患病率、其影响以及与POCD的关联。考虑了加剧营养不良的因素，如慢性疾病和功能下降。该研究还检查了POCD的发生率、其与冠状动脉旁路移植术（CABG）手术的主要关联，以及营养不良对炎症、肺和心力衰竭以及肾损伤等并发症的影响。：研究结果显示，46.4%的术前心脏手术患者存在营养不良，这与慢性疾病和功能下降有关。营养不良显著导致炎症和并发症，包括POCD，其发生率在15%至50%之间。CABG手术尤其与POCD相关，营养不良会延长重症监护时间，同时增加对外科手术应激的易感性。：该综述强调了营养在康复中的关键作用，并主张为不同的心脏手术患者量身定制一种普遍认可的营养评估工具。该综述强调术前强化营养作为减轻炎症和改善认知功能的潜在策略，突出了将营养筛查纳入临床实践以优化高危心脏手术患者预后的必要性。然而，迄今为止，大多数数据来自观察性研究；因此，未来需要进行干预性研究，以检验术前强化营养可减轻该患者群体炎症并改善认知功能这一假设。
