Chemokines Are Associated With Delirium After Cardiac Surgery

Abstract

After cardiac surgery, chemokine levels were elevated in patients who developed delirium in the early postoperative period. Because chemokines are capable of disrupting blood-brain barrier integrity in vitro, future studies are needed to define the relationship of these inflammatory mediators to delirium pathogenesis.

Delirium after open heart surgery

“…The incidence of delirium ranges widely from 8.4 to 70% across studies. [3][4][5][6][7][8][9][10][11] In the present study, the incidence of delirium was considerably lower (5.6%) in the first 72 hours after open heart surgery. The wide range of age of the patients, the characteristics of the patients and the ICUs, differences in the sample sizes, and durations of data collections, differences in the delirium scales and diagnostic criteria, and whether the administrator of the CAM-ICU was a physician or a nurse might be reasons for the significantly different results of the studies on the incidence of delirium.…”

“…Complex procedures are not only more likely in the older population, but also involve longer operation durations and higher volume of blood transfusions. Together, these data suggest that the providing of Chang et al [3] 41.7 DSM-4 48-72 56.6 Rudolph et al [11] 29.0 MSI and CAM 48 59.5 Kazmierski et al [8] 8.0 CAM-ICU Retrospective 64.8 Rudolph et al [22] 21. 4 MSI and CAM 24-48-72 70.5 Rudolph et al [23] 52.0 MSI 48 73.7 Boogaard et al [24] 19. adequate cerebral blood flow and monitoring should be emphasized to avoid hemodynamic fluctuations and micro-embolism during surgery.…”

“…It has been shown that the incidence of delirium increases with age. [11] In addition to the use of different study designs and methods, different diagnostic scales, and the fact that most of the previous studies were retrospective, the year of publications might be also one of the reasons for this discrepancy, as more recent studies reported lower incidences. [8] Despite the prevalence and adverse clinical effects of delirium, it is often overlooked by health care providers.…”

Fisiopatologia imuno-inflamatória do delirium: revisão da literatura

“…Rudolph et al (2008), evidenciaram aumento significativos de quimiocinas, sabidamente envolvidas na migração leucocitária para SNC, em pacientes submetidos a cirurgia cardíaca com by-pass cardiopulmonar com e sem delirium. Neste mesmo estudo, por outro lado, não houve diferença entre as citocinas estudadas nos dois grupos, contudo elas foram medidas tardiamente após 4 o dia pós-operatório.…”

Risk Factors: Pathogenesis, Diagnosis and Management of Delirium

“…7 Other hypotheses invoke abnormalities in melatonin and serotonin, 8 , 9 with abnormal tryptophan metabolism unifying these ideas because tryptophan is Neuronal damage is an alternative explanation, secondary either to oxidative stress 10 or inflammation. Proinflammatory cytokines increase in postoperative delirium, 11 especially interleukin-6 and interleukin-8. 12 .In addition, elevations in C-reactive protein occur in delirious patients.…”