Background: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium.
Methods: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery. Multimodal hemodynamic and perfusion variables were monitored, including central venous oxygenation (ScvO), lactate levels, and non-invasive cerebral oxygenation (rSO), according to a standard anesthesia protocol. Fisher's exact test or Student's -test were used to compare patients who developed post-operative delirium with those who did not ( < 0.05).
Results: We studied 28 patients, age 73 ± 7 years, 60.7% female. Two patients developed post-operative delirium (7.1%). These two patients had fewer years of education than those without delirium ( = 0.031). None of the peri-operative blood pressure variables were associated with incidence of post-operative delirium. In terms of perfusion parameters, postoperative ScvO was lower in the delirium than the non-delirium group, without reaching statistical significance (65 ± 10% vs. 74 ± 5%; = 0.08), but the delta-ScvO (the difference between means post-operative and intra-operative) was associated with post-operative delirium ( = 0.043). Post-operative lactate and rSO variables were not associated with delirium.
Conclusions: Our pilot study suggests an association between delta ScvO and post-operative delirium, and a tendency to lower post-operative ScvO in patients who developed delirium. Further studies are necessary to elucidate this association.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391697 | PMC |
http://dx.doi.org/10.1016/j.bjan.2017.10.002 | DOI Listing |
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