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Postcardiotomy confusion

Robert Jan Osse, Joke H M Tulen, Ad J J C Bogers, Michiel W Hengeveld
AIMS: More than 20% of patients of 65 years or older may develop a delirium after cardiac surgery. Patients with delirium frequently show a disturbed 24-hr motor activity pattern, but objective and quantitative data are scarce. Our aim was to quantify motor activity patterns in elderly patients with or without a postcardiotomy delirium after elective cardiac surgery. METHODS: Wrist-actigraphy was used to quantify 24-hr motor activity patterns for a 5-day period following cardiac surgery in 79 patients of 65 years or older...
February 2009: Psychiatry and Clinical Neurosciences
A M Russo, W H O'Connor, H L Waxman
Cardiac tamponade, a potentially lethal complication following cardiac surgery, may present either early or late postoperatively and may be difficult to diagnose due to atypical clinical, hemodynamic, or echocardiographic findings. To determine the frequency and clinical features of postoperative cardiac tamponade, we performed a review of 510 consecutive patients who underwent cardiac surgery. The incidence of postoperative cardiac tamponade was 2.0 percent (10/510 patients) and occurred following valvular, bypass, and aortic surgery...
July 1993: Chest
R G Harrell, E Othmer
To examine the relationship between sleep loss and confusion after open-heart surgery, 27 consecutive patients were monitored 1 day preoperatively and 5 days postoperatively with the Folstein Mini-Mental State examination, a modified sleep latency test, and a sleep log. Confusion (low Mini-Mental State scores) peaked on postoperative Days 1 and 2 and correlated with insomnia (sleep time) during the following night but not during the preceding night. The results suggest that sleep loss is not the cause but, rather, a consequence of postcardiotomy confusion...
November 1987: Journal of Clinical Psychiatry
M M Tess
Critical care patients become confused in the intensive care setting. Several dangers exist in acute confusional states. Confused patients jeopardize their own safety, are more likely to die than nonconfused patients and are more likely to become cognitively impaired and require institutionalization. This article reviews the literature about patients experiencing acute confusional states in the critical care setting including intensive care unit (ICU) psychosis, postcardiotomy delirium and confusion in the elderly...
December 1991: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
I S Sveinsson
One hundred heart surgery patients were followed throughout their postoperative periods to assess the incidence and etiology of postcardiotomy delirium. Factors evaluated were: age, sex, history of previous psychiatric illness, history of cerebrovascular disease, cardiac diagnosis and operation, time of anesthesia, time of bypass, time spent in the intensive-care unit, and amount of sleep during the postoperative period. Six patients developed delirium, five of whom had a lucid postoperative interval; four patients had perceptual disturbances only, without loss of contact with reality; three had neurological symptoms with mild confusion; 87 kept a clear mental state...
October 1975: Journal of Thoracic and Cardiovascular Surgery
W R Dubin, H L Field, D R Gastfriend
The literature concerning postcardiotomy delirium contains confusing definitions and contradictory results. In a critical review of the subject, we conclude that cardiac status, the severity of physical illness, the complexity of the surgical procedure, and preoperative organic brain disease are the determining factors in postcardiotomy delirium. Preoperative anxiety, denial, and depression also have some correlation. Age, sex, time on bypass, and preoperative psychological profile seem to have no influence on outcome...
April 1979: Journal of Thoracic and Cardiovascular Surgery
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