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IL-6, Delirium

Leroy Schreuder, Bart J L Eggen, Knut P H Biber, Regien G Schoemaker, Jon D Laman, Sophia E de Rooij
Delirium is a frequent outcome for aged and demented patients that suffer a systemic inflammatory insult. Animal models that reconstruct these etiological processes have potential to provide a better understanding of the pathophysiology of delirium. Therefore, we systematically reviewed animal studies in which systemic inflammation was superimposed on aged or diseased animal models. In total, 77 studies were identified. Aged animals were challenged with a bacterial endotoxin in 29 studies, 25 studies superimposed surgery on aged animals, and in 6 studies a bacterial infection, Escherichia coli (E...
January 11, 2017: Brain, Behavior, and Immunity
Luiz Eduardo Baggio Savio, Mariana G Juste Andrade, Paola de Andrade Mello, Patrícia Teixeira Santana, Aline Cristina Abreu Moreira-Souza, Janaína Kolling, Aline Longoni, Linda Feldbrügge, Yan Wu, Angela T S Wyse, Simon C Robson, Robson Coutinho-Silva
Sepsis results in unfettered inflammation, tissue damage, and multiple organ failure. Diffuse brain dysfunction and neurological manifestations secondary to sepsis are termed sepsis-associated encephalopathy (SAE). Extracellular nucleotides, proinflammatory cytokines, and oxidative stress reactions are associated with delirium and brain injury, and might be linked to the pathophysiology of SAE. P2X7 receptor activation by extracellular ATP leads to maturation and release of IL-1β by immune cells, which stimulates the production of oxygen reactive species...
October 11, 2016: Molecular Neurobiology
Edel Hennessy, Shane Gormley, Ana Belen Lopez-Rodriguez, Caoimhe Murray, Carol Murray, Colm Cunningham
Inflammation influences chronic neurodegeneration but its precise roles are not yet clear. Systemic inflammation caused by infection, trauma or co-morbidity can alter the brain's inflammatory status, produce acute cognitive impairments, such as delirium, and drive new pathology and accelerated decline. Consistent with this, elevated systemic TNF-α is associated with more rapid cognitive decline over 6months in Alzheimer's disease patients. In the current study we challenged normal animals and those with existing progressive neurodegeneration (ME7 prion disease) with TNF-α (i...
January 2017: Brain, Behavior, and Immunity
Jan Hirsch, Susana Vacas, Niccolo Terrando, Miao Yuan, Laura P Sands, Joel Kramer, Kevin Bozic, Mervyn M Maze, Jacqueline M Leung
BACKGROUND: Postoperative delirium is prevalent in older patients and associated with worse outcomes. Recent data in animal studies demonstrate increases in inflammatory markers in plasma and cerebrospinal fluid (CSF) even after aseptic surgery, suggesting that inflammation of the central nervous system may be part of the pathogenesis of postoperative cognitive changes. We investigated the hypothesis that neuroinflammation was an important cause for postoperative delirium and cognitive dysfunction after major non-cardiac surgery...
2016: Journal of Neuroinflammation
Bjørn Erik Neerland, Roanna J Hall, Ingebjørg Seljeflot, Frede Frihagen, Alasdair M J MacLullich, Johan Raeder, Torgeir Bruun Wyller, Leiv Otto Watne
OBJECTIVES: To examine whether delirium in individuals with hip fracture is associated with high C-reactive protein (CRP), interleukin-6 (IL-6), and soluble IL-6 receptor (sIL-6R) levels in the cerebrospinal fluid (CSF). DESIGN: Prospective cohort study. SETTING: Two university hospitals in Oslo, Norway, and Edinburgh, United Kingdom. PARTICIPANTS: Individuals admitted with acute hip fracture (N = 151). MEASUREMENTS: Participants were assessed for delirium pre- and postoperatively using the Confusion Assessment Method...
July 2016: Journal of the American Geriatrics Society
Woo-Keun Kwon, Jong Hyun Kim, Ji-Hye Lee, Byung-Gun Lim, Il-ok Lee, Seong Beom Koh, Taek Hyun Kwon
OBJECTIVE: The preferred choice of anesthesia for deep brain stimulation (DBS) has been local anesthesia due to the need of patients' cooperation during the procedure, and concern on the interference of sedatives on microelectrode recording (MER) results. However, local anesthesia during the whole procedure may be impossible in some patients due to uncontrolled anxiety, fear, delirium or exhaustion. Therefore, sedative drugs have been used for DBS, but findings of MER during the procedures have not been reported in detail, especially in the globus pallidus internus (GPi)...
April 2016: Clinical Neurology and Neurosurgery
Y Sun, J Liu, X Yuan, Y Li
AIM: The present study aimed to investigate the effects of dexmedetomidine on emergence delirium (ED) in pediatric patients undergoing cardiac surgery. METHODS: Fifty children of both sexes aged 1-6 years weighing 10-25 kilograms, with American Society of Anesthesiologists (ASA) physical status grade II, undergoing sevoflurane-based general anesthesia for elective cardiac surgery were randomly assigned to two groups. The dexmedetomidine group (group D, n=25) received 0...
November 6, 2015: Minerva Pediatrica
Lingling Ding, Hong Zhang, Weidong Mi, Tao Wang, Yan He, Xu Zhang, Xin Ma, Hongzhao Li
OBJECTIVE: The purpose of the study was to evaluate the neuroprotective effect of dexmedetomidine on anesthesia recovery period and postoperative cognitive function of patients after robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. METHODS: A total of 40 elective patients who would undergo robot-assisted laparoscopic radical cystectomy and ileal conduit diversion. They were randomly divided into two groups in a double-blind manner. After pneumoperitoneum established, all patients adopted 40° trendelenberg position...
2015: International Journal of Clinical and Experimental Medicine
Inge C M Hoogland, Carin Houbolt, David J van Westerloo, Willem A van Gool, Diederik van de Beek
BACKGROUND: Animal studies show that peripheral inflammatory stimuli may activate microglial cells in the brain implicating an important role for microglia in sepsis-associated delirium. We systematically reviewed animal experiments related to the effects of systemic inflammation on the microglial and inflammatory response in the brain. METHODS: We searched PubMed between January 1, 1950 and December 1, 2013 and Embase between January 1, 1988 and December 1, 2013 for animal studies on the influence of peripheral inflammatory stimuli on microglia and the brain...
June 6, 2015: Journal of Neuroinflammation
Lingling Ding, Hong Zhang, Weidong Mi, Yan He, Xu Zhang, Xin Ma, Hongzhao Li
OBJECTIVE: To evaluate the neuroprotective effect of dexmedetomidine on recovery period of anesthesia and postoperative cognitive function after robot assisted laparoscopicradical prostatectomy in the elderly people. METHODS: A total of 100 elderly patients who underwent robotic laparoscopic radical prostatectomy were divided into 2 groups: A dexmedetomidine group (n=50) and a control group (n=50). Patients in the dexmedetomidine group were given a loading dosage of dexmedetomidine [0...
February 2015: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Christopher B Tan, Jackson Ng, Rajkumar Jeganathan, Fernando Kawai, Cynthia X Pan, Simcha Pollock, James Turner, Steven Cohen, Mitchell Chorost
BACKGROUND: Postoperative delirium in the elderly is a growing concern. Data regarding significant differences in postoperative cognitive dysfunction (POCD) in elderly persons undergoing laparoscopic versus open colon resection are not well established. OBJECTIVES: The goal of this study was to compare the incidence of POCD in laparoscopic versus open colon surgery in an elderly population. DESIGN AND SETTING: A prospective nonrandomized pilot study was conducted at an urban tertiary care hospital...
2015: Dementia and Geriatric Cognitive Disorders
Angelique Egberts, Eline H A Wijnbeld, Durk Fekkes, Milly A van der Ploeg, Gijsbertus Ziere, Herbert Hooijkaas, Tischa J M van der Cammen, Francesco U S Mattace-Raso
BACKGROUND/AIMS: The diagnosis of delirium is not supported by specific biomarkers. In a previous study, high neopterin levels were found in patients with a postoperative delirium. In the present study, we investigated levels of neopterin, interleukin-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in acutely ill admitted elderly patients with and without a delirium. METHODS: Plasma/serum levels of neopterin, IL-6 and IGF-1 were determined in patients aged ≥65 years admitted to the wards of Internal Medicine and Geriatrics...
2015: Dementia and Geriatric Cognitive Disorders
Miriam Capri, Stella Lukas Yani, Rabih Chattat, Daniela Fortuna, Laura Bucci, Catia Lanzarini, Cristina Morsiani, Fausto Catena, Luca Ansaloni, Marco Adversi, Maria Rita Melotti, Gianfranco Di Nino, Claudio Franceschi
BACKGROUND: Post-operative delirium (POD) is a common complication in elderly patients undergoing surgery, but the underpinning causes are not clear. We hypothesized that inflammaging, the subclinical low and chronic grade inflammation characteristic of old people, can contribute to POD onset. Accordingly, we investigated the association of pre-operative and circulating cytokines in elderly patients (>65 years), admitted for elective and emergency surgery. METHODS: This is a secondary analysis of a sub-cohort of patients belonging to a previous large case-control study, where 351 patients were clinically and cognitively thoroughly characterized, together with the assessment of POD (47 patients) by confusion assessment method and delirium rating scale...
2014: Frontiers in Endocrinology
Yung-Yen Cheng, Sunny Jui-Shan Lin, Chih-Hung Chang, Chien-Jung Lin, Chen-Chen Tsai, Yi-Chang Su
OBJECTIVE: To evaluate and compare the predictive value of the physical signs mentioned by ZHANG Zhong-jing in Treatise on Cold Damaged Diseases (Shang Han Lun), together with other clinically determined diagnostic scores and laboratory values in modern medicine on 28-day mortality in septic patients. METHODS: Three-year prospective observation was conducted in medical intensive care unit in two local community hospitals. In all, 126 patients with severe sepsis and/or septic shock were consecutively enrolled...
September 24, 2014: Chinese Journal of Integrative Medicine
Huawei Huang, Li Jiang, Ling Shen, Guobin Zhang, Bo Zhu, Jiajia Cheng, Xiuming Xi
BACKGROUND: Sleep deprivation is common in critically ill patients in intensive care units (ICU). It can result in delirium, difficulty weaning, repeated nosocomial infections, prolonged ICU length of stay and increased ICU mortality. Melatonin, a physiological sleep regulator, is well known to benefit sleep quality in certain people, but evidence for the effectiveness in ICU sleep disturbance is limited. METHODS/DESIGN: This study has a prospective, randomized, double-blind, controlled, parallel-group design...
2014: Trials
Cristiane Ritter, Cristiane D Tomasi, Felipe Dal-Pizzol, Bernardo Bollen Pinto, Alex Dyson, Aline S de Miranda, Clarissa M Comim, Márcio Soares, Antonio L Teixeira, João Quevedo, Mervyn Singer
INTRODUCTION: Delirium is a common occurrence in critically ill patients and is associated with an increase in morbidity and mortality. Septic patients with delirium may differ from a general critically ill population. The aim of this investigation was to study the relationship between systemic inflammation and the development of delirium in septic and non-septic critically ill patients. METHODS: We performed a prospective cohort study in a 20-bed mixed intensive care unit (ICU) including 78 (delirium = 31; non-delirium = 47) consecutive patients admitted for more than 24 hours...
2014: Critical Care: the Official Journal of the Critical Care Forum
Sun-wook Kim, Ho-Seong Han, Hee-won Jung, Kwang-il Kim, Dae Wook Hwang, Sung-Bum Kang, Cheol-Ho Kim
IMPORTANCE: The number of geriatric patients who undergo surgery has been increasing, but there are insufficient tools to predict postoperative outcomes in the elderly. OBJECTIVE: To design a predictive model for adverse outcomes in older surgical patients. DESIGN, SETTING, AND PARTICIPANTS: From October 19, 2011, to July 31, 2012, a single tertiary care center enrolled 275 consecutive elderly patients (aged ≥65 years) undergoing intermediate-risk or high-risk elective operations in the Department of Surgery...
July 2014: JAMA Surgery
C S Burkhart, S Dell-Kuster, M Siegemund, H Pargger, S Marsch, S P Strebel, L A Steiner
BACKGROUND: Data regarding immunomodulatory effects of parenteral n-3 fatty acids in sepsis are conflicting. In this study, the effect of administration of parenteral n-3 fatty acids on markers of brain injury, incidence of sepsis-associated delirium, and inflammatory mediators in septic patients was investigated. METHODS: Fifty patients with sepsis were randomized to receive either 2 ml/kg/day of a lipid emulsion containing highly refined fish oil (equivalent to n-3 fatty acids 0...
July 2014: Acta Anaesthesiologica Scandinavica
Jakub Kazmierski, Andrzej Banys, Joanna Latek, Julius Bourke, Ryszard Jaszewski, Tomasz Sobow, Iwona Kloszewska
AIMS: The present study aimed to determine the impact of mild cognitive impairment (MCI) on the development of postoperative delirium and, secondly, to assess the association between MCI and raised perioperative cortisol, cytokine, cobalamin and homocysteine levels. METHODS: The study recruited 113 consecutive adult patients scheduled for cardiac surgery with cardiopulmonary bypass. The patients were examined preoperatively with the Montreal Cognitive Assessment and Trail Making Test...
2014: Dementia and Geriatric Cognitive Disorders
Ariel D Stock, Jing Wen, Chaim Putterman
Patients with systemic lupus erythematosus (SLE) can experience acute neurological events such as seizures, cerebrovascular accidents, and delirium, psychiatric conditions including depression, anxiety, and psychosis, as well as memory loss and general cognitive decline. Neuropsychiatric SLE (NPSLE) occurs in between 30 and 40% of SLE patients, can constitute the initial patient presentation, and may occur outside the greater context of an SLE flare. Current efforts to elucidate the mechanistic underpinnings of NPSLE are focused on several different and potentially complementary pathways, including thrombosis, brain autoreactive antibodies, and complement deposition...
December 25, 2013: Frontiers in Immunology
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