Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery

Post-Operative Cognitive Impairment: A Cognitive Epidemiology Perspective

“…Self-reported education was not associated with POD risk ( Cavallari et al 2016 , 2017 ; Cizginer et al 2017 ; Hshiesh et al 2017 ; Inouye et al 2016 ; Tripp et al 2021 ; Vasunilashorn et al 2017 ). Another large study, the PAWEL study based in Germany ( Deeken et al 2022 ), as well as smaller cohort studies from Europe, Asia, and South America support these null results ( Jiang et al 2017 ; Kazmierski et al 2013 ; Mahanna-Gabrielli et al 2020 ; Puustinen et al 2016 ; Ristescu et al 2021 ; Sauer et al 2017 ; Seo et al 2014 ; Xue et al 2016 ), whereas other investigations do suggest a low education as a risk factor for POD ( Dworkin et al 2016 ; Gu et al 2021 ; Guan et al 2021 ; Huang et al 2021 ; Ma et al 2021 ; McAlpine et al 2008 ; Ordóñez-Velasco and Hernández-Leiva 2021 ; Schoen et al 2011 ; Sprung et al 2017 ; Su et al 2019 ; Tenpaku et al 2021 ; Tobar et al 2018 ). Interestingly, one recent Chinese study of 323 laryngectomy patients reported evidence in the opposite direction.…”

Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis

“…A total of 72 studies published between 1998 and 2022 were included in the systematic review and meta-analysis [ 7 , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] ,…”

Effects of intraoperative adrenergic administration on postoperative hyperlactatemia in open colon surgery: an observational study

“…The patients enrolled in this study were part of a project designed to evaluate the association between perioperative perfusion and postoperative delirium; these results were recently published. 32 The patients were contacted by the research team once admitted to request their participation in the study, informed consent, baseline sampling, and registration of preoperative baseline characteristics. A secondary a priori objective of the project was to study perioperative perfusion disorders, specifically to evaluate the association between the evolution of postoperative perfusion parameters and hypotension and/or intraoperative interventions to manage hypotension (such as administration of fluids or vasoactive agents).…”

“…In the case of hypotension, pulse pressure variability was monitored to evaluate the need to administer an additional fluid bolus. 32 In the case of severe hypotension or hypotension unresponsive to fluids, vasopressors were administered according to the following protocol: in the absence of tachycardia, a 6–12 mg bolus of ephedrine was administered; if there was no response to ephedrine or if ephedrine was contraindicated, a 50–100 μg bolus of phenylephrine was administered. Finally, if there was no response to phenylephrine, norepinephrine infusion was initiated, targeting a MAP of 65–85 mmHg.…”

“…The sample size was calculated for the primary objective of this research project, as previously reported. 32 Baseline patient characteristics and intra- and postoperative measurements are expressed as a proportion or the mean ± SD. A chi-squared independence test, Fisher's exact test, or Student's t -test was used to evaluate associations between hyperlactatemia and baseline or intraoperative variables.…”