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Postoperative delirium after cardiac surgery associated with perioperative gut microbiota dysbiosis: Evidence from human and antibiotic-treated mouse model.
Anaesth Crit Care Pain Med
January 2025
Department of Anesthesiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, China; The Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, Shijiazhuang, Hebei, 050000, China. Electronic address:
Background: Research links gut microbiota to postoperative delirium (POD) through the gut-brain axis. However, changes in gut microbiota and fecal short-chain fatty acids (SCFAs) in POD patients during the perioperative period and their association with POD are unclear.
Methods: We conducted a nested case-control study among patients undergoing off-pump coronary artery bypass grafting, focusing on POD as the main outcome.
Clinical and intracranial electrophysiological signatures of post-operative and post-ictal delirium.
Clin Neurophysiol
January 2025
Department of Neurosurgery, The University of Iowa, Iowa City, IA 52242, USA; Iowa Neuroscience Institute, The University of Iowa, Iowa City, IA 52242, USA.
Objectives: (1) Gain insight into the mechanisms of postoperative delirium (POD). (2) Determine mechanistic overlap with post-ictal delirium (PID). Epilepsy patients undergoing intracranial electrophysiological monitoring can experience both POD and PID, and thus are suitable subjects for these investigations.
View Article and Find Full Text PDFEffects of Implementing an Enhanced Recovery After Cardiac Surgery Protocol with On-Table Extubation on Patient Outcome and Satisfaction-A Before-After Study.
J Clin Med
January 2025
Department of Anesthesiology, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
: Enhanced recovery after surgery (ERAS) protocols aim to improve clinical outcomes, shorten hospital length of stay (LOS), and reduce costs through a multidisciplinary perioperative approach. Although introduced in colorectal surgery, they are less established in cardiac surgery, especially in combination with on-table extubation (OTE). This study evaluates the impact of a novel ERAS concept with OTE (RERACS) in elective aortic-valve-replacement and coronary bypass surgery.
View Article and Find Full Text PDFThe Effect of Anesthetic Depth on the Occurrence of Emergence Delirium in Children Undergoing Strabismus Surgery: A Prospective Observational Study.
Biomedicines
December 2024
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.
Background/objectives: Emergence delirium (ED) is one of the most frequent postoperative complications in pediatric patients after general anesthesia. In adults, a deeper intraoperative level of anesthesia has been reported as an independent predictor of postoperative delirium. However, the effect of anesthetic depth on ED has rarely been demonstrated in the pediatric population.
View Article and Find Full Text PDFSurgery impairs glymphatic activity and cognitive function in aged mice.
Mol Brain
January 2025
Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, 10032, USA.
Delirium is a common complication in elderly surgical patients and is associated with an increased risk of dementia. Although advanced age is a major risk factor, the mechanisms underlying postoperative delirium remain poorly understood. The glymphatic system, a brain-wide network of perivascular pathways, facilitates cerebrospinal fluid (CSF) flow and supports the clearance of metabolic waste.
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