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Postoperative delirium

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https://www.readbyqxmd.com/read/29230573/incidence-of-perioperative-stroke-in-clampless-aortic-anastomosis-during-off-pump-coronary-artery-bypass-grafting
#1
Francesco Formica, Giuseppe Tata, Gurmeet Singh, Serena Mariani, Stefano D'Alessandro, Luigi Amerigo Messina, Fabio Sangalli, Giovanni Paolini
This study aimed to assess if clampless off-pump coronary artery bypass grafting (OPCAB) decreases the incidence of perioperative stroke (POS) rate and in-hospital mortality. The secondary aim was to evaluate 12-year rates of overall mortality. Between January 2003 to December 2015, data of 645 consecutive patients undergoing isolated CABG were retrospectively collected. 363 underwent aortic no-touch OPCAB (No-touch group) and 282 underwent OPCAB with the Heartstring device (HS group). In-hospital mortality and perioperative stroke rate as primary endpoint, as well as long-term follow-up outcome were analysed...
December 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29224711/-risk-factors-associated-with-anesthesia-emergence-delirium-in-children-undergoing-outpatient-surgery
#2
Ana Carolina Tavares Paes Barreto, Ana Carolina Rangel da Rocha Paschoal, Carolina Barbosa Farias, Paulo Sérgio Gomes Nogueira Borges, Rebeca Gonelli Albanez da Cunha Andrade, Flávia Augusta de Orange
INTRODUCTION: Anesthesia emergence delirium (AED) is a self-limiting clinical phenomenon very common in children. Although pathophysiology is still uncertain, some factors seem to be involved, such as rapid awakening in an unknown environment, agitation during anesthetic induction, preoperative anxiety, environmental disorders, use of preanesthetic medication, use of inhalational anesthetics, and postoperative pain. OBJECTIVE: To determine the prevalence and risk factors associated with AED in children undergoing outpatient surgery...
December 7, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29221748/hydroxyethyl-starch-is-associated-with-early-postoperative-delirium-in-patients-undergoing-esophagectomy
#3
Dae Myung Jung, Hyun Joo Ahn, Mikyung Yang, Jie Ae Kim, Duck Kyung Kim, Sangmin Maria Lee, Joo Hyun Park
OBJECTIVE: Postoperative delirium is associated with longer hospital stay and increased morbidities. Patients undergoing esophagectomy have a high chance of developing postoperative delirium because of their advanced age, comorbidities, and intensive care unit care. In this study, we investigated the risk factors of early postoperative delirium in patients undergoing esophagectomy, focusing on perioperative fluid type to test the hypothesis that colloids with high oncotic pressure and anti-inflammatory action would decrease the incidence of postoperative delirium compared with crystalloids...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29221736/differential-effects-of-operative-complications-on-survival-after-surgery-for-primary-lung-cancer
#4
Felix G Fernandez, Andrzej S Kosinski, Anthony P Furnary, Mark Onaitis, Sunghee Kim, Robert H Habib, Betty C Tong, Patricia Cowper, Daniel Boffa, Jeffrey P Jacobs, Cameron D Wright, Joe B Putnam
OBJECTIVE: Complications adversely affect survival after lung cancer surgery. We tested the hypothesis that effects of complications after lung cancer surgery on survival vary substantially across the spectrum of postoperative complications. METHODS: The Society of Thoracic Surgeons General Thoracic Surgery Database was linked to Medicare data for lung cancer resections from 2002 through 2013. Linkage was achieved for 29,899 patients. A survival model was created that included operative complications as explanatory variables and adjusted for relevant baseline covariates...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29203991/postoperative-delirium-in-indian-patients-following-major-abdominal-surgery-for-cancer-risk-factors-and-associations
#5
Vibhawari Dhakharia, Subir Sinha, Jaydip Bhaumik
Postoperative delirium (POD) is not uncommon following major abdominal surgery with its incidence ranging between five and 51%. As cancer affects disproportionately, the population older than 65 years and as delirium is more common in the elderly, surgical oncology patients are at a higher risk of developing POD. The present study was undertaken to explore the impact and associations of POD in Indian patients undergoing oncological major abdominal surgery. A retrospective review of the electronic medical records in a tertiary cancer care institution of all postoperative patients who had undergone major gastrointestinal gynaecological and urological abdominal surgery for cancer and required psycho-oncology referral was performed...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29194309/care-of-the-older-adult-with-postoperative-delirium-an-interprofessional-simulation-for-undergraduate-nursing-students
#6
Kimberly D Davis, Carla Nye
Because of the expanding older adult population, undergraduate nursing students need to be introduced to the unique challenges of taking care of older adults. Using simulation to demonstrate some of these challenges allows these entry-level students to learn in a nonthreatening environment. By focusing on an older adult patient who is experiencing postoperative delirium in a simulation, students can practice not only how to complete a safety assessment but also effective communication skills with the patient, family, and members of the interprofessional health care team...
March 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29193248/impact-of-muscle-volume-and-function-decline-in-patients-undergoing-surgical-resection-for-hepatocellular-carcinoma
#7
Atsushi Hiraoka, Yasuhiro Otsuka, Hideki Kawasaki, Hirofumi Izumoto, Hidetaro Ueki, Shogo Kitahata, Toshihiko Aibiki, Tomonari Okudaira, Hiroka Yamago, Yuji Miyamoto, Ryuichiro Iwasaki, Hideomi Tomida, Kenichiro Mori, Hideki Miyata, Eiji Tsubouchi, Masato Kishida, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, Tomoyuki Ninomiya, Izumi Mori, Yoichi Hiasa, Kojiro Michitaka
BACKGROUND/AIM: We investigated the prognostic impact of muscle volume loss (MVL) and function decline in patients undergoing resection for hepatocellular carcinoma (HCC). MATERIAL/METHODS: We enrolled 171 naïve HCC patients treated with resection from 2007 to 2015, after excluding those lacking spirometry or CT findings, who had received non-curative treatments, or with restrictive or obstructive lung disorders. The median peak expiratory flow rate (%PEF) was set as the cut-off value for muscle function decline and MVL was diagnosed using a previously reported value...
November 28, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29192572/-recognising-postoperative-delirium-in-the-elderly
#8
T Numan, M van den Boogaard, A M Kampen, P J T Rood, L M Peelen, A J C Slooter
OBJECTIVE: To determine the degree of agreement between delirium experts on the diagnosis of delirium based on exactly the same information, and to assess the sensitivity of delirium screening methods used by clinical nurses. DESIGN: Prospective observational longitudinal study. METHOD: Older patients (≥ 60 years) who underwent major surgery were included. During the first three days after surgery they had a standardised cognitive screening test which was recorded on video...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29190460/clinical-outcomes-in-older-surgical-patients-with-mild-cognitive-impairment
#9
Annie M Racine, Tamara G Fong, Yun Gou, Thomas G Travison, Douglas Tommet, Kristen Erickson, Richard N Jones, Bradford C Dickerson, Eran Metzger, Edward R Marcantonio, Eva M Schmitt, Sharon K Inouye
INTRODUCTION: Older adults, including those with mild cognitive impairment (MCI), are increasingly undergoing surgery. METHODS: Relative risks (RRs) of MCI alone or with delirium on adverse outcomes were estimated in an ongoing prospective, observational cohort study of 560 nondemented adults aged ≥70 years. RESULTS: MCI (n = 61, 11%) was associated with increased RR of delirium (RR = 1.9, P < .001) and delirium severity (RR = 4...
November 27, 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/29189623/preoperative-risk-factors-for-subsyndromal-delirium-in-older-adults-who-undergo-joint-replacement-surgery
#10
Dawn L Denny, Glenda Lindseth
BACKGROUND: Older adults with subsyndromal delirium have similar risks for adverse outcomes following joint replacement surgery as those who suffer from delirium. PURPOSE: This study examined relationships among subsyndromal delirium and select preoperative risk factors in older adults following major orthopaedic surgery. METHODS: Delirium assessments of a sample of 62 adults 65 years of age or older were completed on postoperative Days 1, 2, and 3 following joint replacement surgery...
November 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29189383/sinai-abbreviated-geriatric-evaluation-development-and-validation-of-a-practical-test
#11
Mark R Katlic, JoAnn Coleman, Kamran Khan, Susan E Wozniak, Joseph H Abraham
OBJECTIVE: To develop and validate a simple geriatric screening tool that performs as well as more complex assessments BACKGROUND:: Many tools that predict treatment risk in older adults are impractical for routine clinical use. METHODS: We prospectively conducted comprehensive preoperative evaluations on 1025 patients age ≥75 years who presented to Sinai Hospital of Baltimore for major elective surgery, then retrospectively reviewed patients' medical records for occurrence of postoperative outcomes...
November 16, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29187700/sevoflurane-preconditioning-ameliorates-lipopolysaccharide-induced-cognitive-impairment-in-mice
#12
Maiko Satomoto, Zhongliang Sun, Yushi U Adachi, Hiroyuki Kinoshita, Koshi Makita
Systemic inflammation induces brain neuronal inflammation, in turn causing acute cognitive disorders. Furthermore, neuronal inflammation is one cause of postoperative cognitive disorder (POCD) and delirium. However, no sufficiently established pharmacological treatment is available for neurocognitive inflammation. This study evaluated the possible neuroprotective effects of preconditioning with sevoflurane anesthesia on cognition and neuroinflammatory changes in an animal model of lipopolysaccharide (LPS)-induced systemic inflammation...
November 29, 2017: Experimental Animals
https://www.readbyqxmd.com/read/29187413/impact-of-inhalational-versus-intravenous-anaesthesia-on-early-delirium-and-long-term-survival-in-elderly-patients-after-cancer-surgery-study-protocol-of-a-multicentre-open-label-and-randomised-controlled-trial
#13
Yue Zhang, Hui-Juan Li, Dong-Xin Wang, Hui-Qun Jia, Xu-De Sun, Ling-Hui Pan, Qing-Shan Ye, Wen Ouyang, Zhen Jia, Fang-Xiang Zhang, Yong-Qing Guo, Yan-Qiu Ai, Bin-Jiang Zhao, Xu-Dong Yang, Qin-Gong Zhang, Ning Yin, Hong-Yu Tan, Zhi-Heng Liu, Jian-Bo Yu, Daqing Ma
INTRODUCTION: Elderly patients who have solid organ cancer often receive surgery. Some of them may develop delirium after surgery and delirium development is associated with worse outcomes. Furthermore, despite all of the advances in medical care, the long-term survival in cancer patients is far from optimal. Evidences suggest that choice of anaesthetics during surgery, that is, either inhalational or intravenous anaesthetics, may influence outcomes. However, the impact of general anaesthesia type on the occurrence of postoperative delirium is inconclusive...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29181397/preoperative-c-reactive-protein-as-a-risk-factor-for-postoperative-delirium-in-elderly-patients-undergoing-laparoscopic-surgery-for-colon-carcinoma
#14
Dong Xiang, Hailin Xing, Huiyu Tai, Guozhu Xie
Background: Postoperative delirium (POD) is a very common complication in operative disciplines, especially in those elderly patients after cardiac surgery. This study aimed to investigate the relationship between C-reactive protein (CRP) and POD in elderly patients undergoing laparoscopic surgery for colon carcinoma. Methods: 160 elderly patients scheduled to undergo selective laparoscopic surgery for colon carcinoma were prospectively recruited in this present study...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29178096/-risk-factors-and-outcomes-of-postoperative-delirium-in-colorectal-cancer-patients-over-60-years
#15
Haitao Zhang, Yuanzhi Tang, Ying Qin
OBJECTIVE: To determine the incidence, risk factors and clinical outcomes of postoperative delirium in colorectal cancer patients over 60 years. METHODS: Consecutive 382 patients older than 60 years undergoing colorectal cancer surgery at Shenzhen Second People's Hospital from June 2013 to June 2016 were recruited prospectively in this study. These patients were evaluated daily after surgery for 7 days by confusion assessment method. Clinical outcomes were compared between patients with and without postoperative delirium, including postoperative complications, length of hospital stay, and mortality within 30 days...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29174758/a-proactive-approach-to-high-risk-delirium-patients-undergoing-total-joint-arthroplasty
#16
Andres F Duque, Zachary D Post, Fabio R Orozco, Rex W Lutz, Alvin C Ong
BACKGROUND: Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA. METHODS: Our group developed a protocol to identify and prevent delirium in patients undergoing TJA...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29173309/delirium-in-hospitalized-children-with-cancer-incidence-and-associated-risk-factors
#17
Chani Traube, Sydney Ariagno, Francesca Thau, Lynne Rosenberg, Elizabeth A Mauer, Linda M Gerber, David Pritchard, Julia Kearney, Bruce M Greenwald, Gabrielle Silver
OBJECTIVE: To assess the incidence of delirium and its risk factors in hospitalized children with cancer. STUDY DESIGN: In this cohort study, all consecutive admissions to a pediatric cancer service over a 3-month period were prospectively screened for delirium twice daily throughout their hospitalization. Demographic and treatment-related data were collected from the medical record after discharge. RESULTS: A total of 319 consecutive admissions, including 186 patients and 2731 hospital days, were included...
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29166854/a-single-dose-of-dezocine-suppresses-emergence-agitation-in-preschool-children-anesthetized-with-sevoflurane-remifentanil
#18
Li-Jun An, Yang Zhang, Zheng Su, Xian-Long Zhang, Hai-Lin Liu, Zhi-Jie Zhang, Jian-Lin Hu, Shi-Tong Li
BACKGROUND: Emergence agitation (EA) is a common phenomenon in preschool children during emergence from general anesthesia. This study evaluated the safety and efficacy of dezocine for emergence agitation in preschool children anesthetized with sevoflurane-remifentanil. METHODS: A total of 100 preschool children, scheduled for elective laparoscopic repair of an inguinal hernia by high ligation of the hernia sac under sevoflurane-remifentanil anesthesia were randomized into two groups: Group C (n = 50) received Ringer's lactate 10 mL and Group D received Ringer's lactate 10 mL containing dezocine 0...
November 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29162132/comparison-of-the-effect-of-high-versus-low-mean-arterial-pressure-levels-on-clinical-outcomes-and-complications-in-elderly-patients-during-non-cardiothoracic-surgery-under-general-anesthesia-study-protocol-for-a-randomized-controlled-trial
#19
Anmin Hu, Yan Qiu, Peng Zhang, Bailong Hu, Yali Yang, Shutao Li, Rui Zhao, Zhongjun Zhang, Yaoxian Zhang, Zihao Zheng, Chen Qiu, Furong Li, Xiaolei Gong
BACKGROUND: Intraoperative blood pressure (BP) is a concern in daily clinic anesthesia and contributes to the differences in clinical outcome. We conducted a randomized controlled trial (RCT) to compare the effect of high vs. low mean arterial pressure (MAP) levels on clinical outcomes and complications in elderly patients under general anesthesia (GA). METHODS: In this multicenter, randomized, parallel-controlled, open-label, assessor-blinded clinical trial, 322 patients aged more than 65 years will be randomized for a low-level MAP (60-70 mmHg) or high-level MAP (90-100 mmHg) during non-cardiothoracic surgery under GA...
November 21, 2017: Trials
https://www.readbyqxmd.com/read/29161390/thiopental-to-desflurane-an-anaesthetic-journey-where-are-we-going-next
#20
J R Sneyd
Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and paralysis with manageable off-target effects. The availability of these agents at generic prices inhibits commercial interest and this is reflected in the limited number of current anaesthetic drug development projects...
December 1, 2017: British Journal of Anaesthesia
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