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https://www.readbyqxmd.com/read/29761891/processed-electroencephalogram-and-evoked-potential-techniques-for-amelioration-of-postoperative-delirium-and-cognitive-dysfunction-following-non-cardiac-and-non-neurosurgical-procedures-in-adults
#1
REVIEW
Yodying Punjasawadwong, Waraporn Chau-In, Malinee Laopaiboon, Sirivimol Punjasawadwong, Pathomporn Pin-On
BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through optimization of anaesthetic doses. OBJECTIVES: To assess whether the use of processed EEG or auditory evoked potential (AEP) indices (bispectral index (BIS), narcotrend index, cerebral state index, state entropy and response entropy, patient state index, index of consciousness, A-line autoregressive index, and auditory evoked potentials (AEP index)) as guides to anaesthetic delivery can reduce the risk of POD and POCD in non-cardiac surgical or non-neurosurgical adult patients undergoing general anaesthesia compared with standard practice where only clinical signs are used...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29761010/central-cholinergic-system-mediates-working-memory-deficit-induced-by-anesthesia-surgery-in-adult-mice
#2
Xiao Zhang, Xuliang Jiang, Lili Huang, Weitian Tian, Xuemei Chen, Xiyao Gu, Weifeng Yu, Jie Tian, Diansan Su
Background: Postoperative cognitive dysfunction (POCD) is consistently associated with increased morbidity and mortality, which has become a major concern of patients and caregivers. Although POCD occurs mainly in aged patients, it happens at any age. Previous studies demonstrated that anesthesia/surgery had no effects on reference memory of adult mice. However, whether it impairs working memory remains unclear. Working memory deficit would result in many deficits of executive function...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29756691/cerebrovascular-autoregulation-impairments-during-cardiac-surgery-with-cardiopulmonary-bypass-are-related-to-postoperative-cognitive-deterioration-prospective-observational-study
#3
Birute Kumpaitiene, Milda Svagzdiene, Edmundas Sirvinskas, Virginija Adomaitiene, Vytautas Petkus, Rolandas Zakelis, Solventa Krakauskaite, Romanas Chomskis, Arminas Ragauskas, Teodoro F Dagi, Rimantas Benetis
BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs in approximately 33-83% of patients after cardiac surgery with cardiopulmonary bypass (CPB). Recent clinical data suggest that real-time, intraoperative monitoring of patient- specific cerebrovascular autoregulation (CA) may help to prevent POCD by detecting individual critical limits for mean arterial pressure (MAP) outside which CA is impaired. Objectives of the study were to detect the episodes of impaired CA during cardiac surgery with CPB, and to investigate the association between CA impairment and POCD...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29754693/preoperative-6-minute-walk-distance-is-associated-with-postoperative-cognitive-dysfunction
#4
Kazuhiro Hayashi, Hideki Oshima, Miho Shimizu, Kiyonori Kobayashi, Shigeyuki Matsui, Yoshihiro Nishida, Akihiko Usui
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation...
April 25, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29743884/exploring-postoperative-cognitive-dysfunction-and-delirium-in-noncardiac-surgery-using-mri-a-systematic-review
#5
REVIEW
Chenxi Huang, Johan Mårtensson, Ismail Gögenur, Mohammad Sohail Asghar
Surgical patients are at high risk of developing postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). POCD and POD are associated with increased morbidity and mortality and worsening functional outcomes leading to severe socioeconomic consequences for the patient and the society in general. Magnetic resonance imaging (MRI) offers a unique opportunity to study the anatomy and function of the brain. MRI thus plays an important role in elucidating the neuronal component of POCD and POD...
2018: Neural Plasticity
https://www.readbyqxmd.com/read/29709021/validity-of-a-point-of-care-nerve-conduction-device-for-polyneuropathy-identification-in-older-adults-with-diabetes-results-from-the-canadian-study-of-longevity-in-type-1-diabetes
#6
Daniel Scarr, Leif E Lovblom, Nancy Cardinez, Andrej Orszag, Mohammed A Farooqi, Genevieve Boulet, Alanna Weisman, Julie A Lovshin, Mylan Ngo, Narinder Paul, Hillary A Keenan, Michael H Brent, David Z Cherney, Vera Bril, Bruce A Perkins
OBJECTIVE: Point-of-care nerve conduction devices (POCD) have been studied in younger patients and may facilitate screening for polyneuropathy in non-specialized clinical settings. However, performance may be impaired with advanced age owing to age-related changes in nerve conduction. We aimed to evaluate the validity of a POCD as a proxy for standard nerve conduction studies (NCS) in older adults with type 1 diabetes (T1D). METHODS: Sural nerve amplitude potential (AMP) and sural nerve conduction velocity (CV) was measured in 68 participants with ≥ 50 years T1D duration and 71 controls (from age/sex-matched subgroups) using POCD and NCS protocols...
2018: PloS One
https://www.readbyqxmd.com/read/29678619/effect-of-goal-directed-fluid-therapy-on-early-cognitive-function-in-elderly-patients-with-spinal-stenosis
#7
Na Zhang, Min Liang, Dan-Dan Zhang, Yi-Rong Xiao, Yan-Zhen Li, You-Guang Gao, Hong-da Cai, Xian-Zhong Lin, Cai-Zhu Lin, Kai Zeng, Xiao-Dan Wu
PURPOSE: To explore effect of goal-directed fluid therapy (GDFT) on early cognitive function in elderly patients with spinal stenosis. METHODS: 83 elderly patients with spinal stenosis were randomly classified into two groups: control group (n = 40) and GDFT group (n = 43). The Montreal Cognitive Assessment (MoCA) score, IL-6 and S100β levels, hemodynamic parameters, cerebral oxygen saturation (rSO2 ), arterial lactic acid values, output of surgery, operation time and cases of hypotension, intraoperative complications within 7 days were recorded for all patients...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29672286/activated-%C3%AE-7nachr-improves-postoperative-cognitive-dysfunction-and-intestinal-injury-induced-by-cardiopulmonary-bypass-in-rats-inhibition-of-the-proinflammatory-response-through-the-th17-immune-response
#8
Keyan Chen, YingJie Sun, Wanwei Dong, Tiezheng Zhang, Nan Zhou, Weiwei Yu, Yugang Diao, Shanbin Guo, Yue Tian
Backgrund/Aims: To investigate the effects of activated α7 nicotinic acetylcholine receptor (α7nAChR) on postoperative cognitive dysfunction (POCD) and intestinal injury induced by cardiopulmonary bypass (CPB) and its relationship with the Th17 response in order to provide a theoretical basis for organ protection and targeted drug therapy during the perioperative period. METHODS: Sprague-Dawley rat models of CPB were established. Rat intestinal and brain injuries were observed after CPB using hematoxylin and eosin staining...
April 16, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29670465/emerging-roles-of-immune-cells-in-postoperative-cognitive-dysfunction
#9
REVIEW
Yue Liu, Yiqing Yin
Postoperative cognitive dysfunction (POCD), a long-lasting cognitive decline after surgery, is currently a major clinical problem with no clear pathophysiological mechanism or effective therapy. Accumulating evidence suggests that neuroinflammation plays a critical role in POCD. After surgery, alarmins are leaked from the injury sites and proinflammatory cytokines are increased in the peripheral circulation. Neurons in the hippocampus, which is responsible for learning and memory, can be damaged by cytokines transmitted to the brain parenchyma...
2018: Mediators of Inflammation
https://www.readbyqxmd.com/read/29665808/critical-role-of-nlrp3-caspase-1-pathway-in-age-dependent-isoflurane-induced-microglial-inflammatory-response-and-cognitive-impairment
#10
Zhi Wang, Shiyu Meng, Lin Cao, Ying Chen, Zhiyi Zuo, Shuling Peng
BACKGROUND: Elderly patients are more likely to suffer from postoperative cognitive dysfunction (POCD) after surgery and anesthesia. Except for declined organ function, the particular pathogenesis of POCD in elderly patients remains unknown. This study is carried out to determine the critical role of the NOD-like receptor protein 3 (NLRP3)-caspase-1 pathway in isoflurane-induced cognitive impairment. METHODS: Young (6-8 months old) and aged (14 months old) healthy male C57BL/6 mice were exposed to 1...
April 17, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29661144/pretreatment-with-nimodipine-reduces-incidence-of-pocd-by-decreasing-calcineurin-mediated-hippocampal-neuroapoptosis-in-aged-rats
#11
Qi Zhang, Yanan Li, Yongjuan Bao, Chunping Yin, Xi Xin, Yangyang Guo, Fang Gao, Shuping Huo, Xiuli Wang, Qiujun Wang
BACKGROUND: Calcineurin (CaN) having a high expression in hippocampal neurons is closely related to apoptosis. Pretreatment with nimodipine can lower the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). However, the relationship between cerebral protective effect of pretreatment with nimodipine and CaN is controversial in the literature. The aim of this study is to evaluate the relationship between neuroprotective effect of nimodipine and CaN on POCD in aged rats...
April 16, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29660304/circadian-rhythm-resynchronization-improved-isoflurane-induced-cognitive-dysfunction-in-aged-mice
#12
Jia Song, Shuaishuai Chu, Yin Cui, Yue Qian, Xiuxiu Li, Fangxia Xu, Xueming Shao, Zhengliang Ma, Tianjiao Xia, Xiaoping Gu
Postoperative cognitive dysfunction (POCD) is a common clinical phenomenon characterized by cognitive deficits in patients after anesthesia and surgery. Advanced age is a significant independent risk factor for POCD. We previously reported that in young mice, sleep-wake rhythm is involved in the isoflurane-induced memory impairment. In present study, we sought to determine whether advanced age increased the risk of POCD through aggravated and prolonged post-anesthetic circadian disruption in the elderly. We constructed POCD model by submitting the mice to 5-h 1...
April 13, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29656802/impact-on-the-brain-of-the-inflammatory-response-to-surgery
#13
REVIEW
Sarah Saxena, Mervyn Maze
The brain is both the orchestrator as well as the target of the innate immune system's response to the aseptic trauma of surgery. When trauma-induced inflammation is not appropriately regulated persistent neuro-inflammation interferes with the synaptic plasticity that underlies the learning and memory aspects of cognition. The complications that ensue, include postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) at two poles of a constellation that is now termed perioperative neurocognitive disorders...
April 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29628565/postoperative-cognitive-dysfunction-in-indian-patients-undergoing-total-knee-replacement-under-spinal-anesthesia
#14
Praful Kilaru, A Ramachandra Reddy, Maryada Venketeshwar Reddy, Brijesh Kidiyoor, Vinay Mathew Joseph, Annapareddy Venkata Gurava Reddy
Introduction: Total knee replacement is a common surgical procedure in the elderly. The number of surgeries has increased owing to the increasing life expectancy of the population and better functional outcomes postsurgery. Postoperative cognitive dysfunction (POCD) is an identified entity postsurgery in elderly but most of the studies have been on patients undergoing cardiac and other nonorthopaedic surgeries. The studies have shown variable incidence due to selection bias. We studied the incidence and probable predictive factors of POCD in elderly Indian population undergoing total knee replacement under spinal anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29620198/isoflurane%C3%A2-induced-postoperative-cognitive-dysfunction-is-mediated-by-hypoxia%C3%A2-inducible-factor%C3%A2-1%C3%AE-%C3%A2-dependent-neuroinflammation-in-aged-rats
#15
Yiyun Cao, Zhengqian Li, Lijun Ma, Cheng Ni, Lunxu Li, Ning Yang, Chengmei Shi, Xiangyang Guo
Elderly patients are at high risk of developing postoperative cognitive dysfunction (POCD) after prolonged exposure to inhaled anesthetics. However, the pathogenesis of POCD remains unknown. Hypoxia‑inducible factor‑1α (HIF‑1α) is activated by inhaled anesthetics. The aim of the present study was to determine the role of HIF‑1α in isoflurane‑induced neuroinflammation and the resulting cognitive impairment. Following a 4‑h exposure to 1.5% isoflurane in 20‑month‑old rats, increased expression of HIF‑1α protein, activation of nuclear factor (NF)‑κB signaling and increased expression of TNF‑1α were observed in the hippocampus of isoflurane‑exposed rats compared with the control group...
April 5, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29615969/postoperative-delirium-learning-and-anesthetic-neurotoxicity-some-perspectives-and-directions
#16
W Alan C Mutch, Renée M El-Gabalawy, M Ruth Graham
Evidence of anesthetic neurotoxicity is unequivocal when studied in animal models. These findings have translated poorly to the clinical domain when equated to postoperative delirium (POD) in adults and postoperative cognitive dysfunction (POCD) in either children or the elderly. In this perspective, we examine various reasons for the differences between animal modeling of neurotoxicity and the clinical situation of POD and POCD and make suggestions as to potential directions for ongoing research. We hypothesize that the animal anesthetic neurotoxicity models are limited, in part, due to failed scaling correction of physiological time...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29589415/perioperative-hyperglycaemia-and-neurocognitive-outcome-after-surgery-a-systematic-review
#17
Jeroen Hermanides, Ega Qeva, Benedikt Preckel, Federico Bilotta
BACKGROUND: Preliminary evidence suggest a possible relationship between perioperative hyperglycaemia, postoperative delirium (POD) or cognitive dysfunction (POCD). We aim to present the available clinical evidence related to chronic (i.e. Diabetes Mellitus) or acute perioperative hyperglycaemia as risk factors for POD/POCD. METHODS: A literature search of EMBASE (via Ovid, 1974-present) online medical database and MEDLINE (via PubMed or Ovid, 1946-present) was performed...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29578249/preoperative-vitamin-d-deficiency-increases-the-risk-of-postoperative-cognitive-dysfunction-a-predefined-exploratory-sub-analysis
#18
Y Zhang, G-J Shan, Y-X Zhang, S-J Cao, S-N Zhu, H-J Li, D Ma, D-X Wang
BACKGROUND: Vitamin D is important for maintaining physiological functions including cognition and its deficiency is associated with the occurrence of cognitive impairment. This study was to explore the association between preoperative vitamin D status and the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing major surgery. METHODS: This was a predefined exploratory sub-analysis of one-centre data from a randomized controlled trial...
March 26, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29571823/dexmedetomidine-promotes-the-recovery-of-neurogenesis-in-aged-mouse-with-postoperative-cognitive-dysfunction
#19
Wen-Xiang Wang, Qiong Wu, Si-Si Liang, Xue-Kang Zhang, Qian Hu, Qiu-Hong Chen, Hai-Jin Huang, Lin Xu, Fo-Quan Lou
Recently, growing evidence has demonstrated Dexmedetomidine (Dex) a promising intervene preventing postoperative cognitive decline (POCD) following surgery, which is associated with neuroinflammation leading to neuronal apoptosis and deregulated neurogenesis. Previous studies suggested the anti-inflammation and anti-neuroapoptosis action of Dex. Therefore we hypothesize the promoting neurogenesis of Dex linked to stimulating BDNF and subsequent p-MPAK production in a rat model of POCD. In the present study, the POCD animal model was established by performing an exploratory laparotomy under isoflurane anaesthesia in old rats, utilizing which Dex response is confirmed by behavioural tests...
March 20, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29568750/the-effect-of-dexmedetomidine-on-cognitive-function-and-protein-expression-of-a-%C3%AE-p-tau-and-psd95-after-extracorporeal-circulation-operation-in-aged-rats
#20
Ying Zhang, Yong Lin, Qing Liu, Xuemei Yuan, Anqiong Mao, Yuexin Liu, Qun Li, Jie Zheng, Bin Hu, Fengxu Yu
Postoperative cognitive dysfunction (POCD) is a kind of serious neurologic complications and dexmedetomidine has a certain effect on POCD. However, functional mechanism of dexmedetomidine on POCD still remains unclear, so the research mainly studied the effect of dexmedetomidine on cognitive function and protein expression in hippocampus and prefrontal cortex cerebrospinal fluid after extracorporeal circulation operation in aged rats. We Found that, compared with POCD group, the cognitive function was improved in POCD + Dex group...
2018: BioMed Research International
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