Dopamine Administration is a Risk Factor for Delirium in Patients Undergoing Coronary Artery Bypass Surgery

Yılmaz, Seyhan; Aksoy, Eray; Diken, Adem İlkay; Yalçınkaya, Adnan; Erol, Mehmet Emir; Çağlı, Kerim

doi:10.1016/j.hlc.2015.09.012

Cited by 19 publications

(21 citation statements)

References 20 publications

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“…Increased dopaminergic transmission is usually accompanied by reduced central cholinergic transmission, which is postulated to be associated with delirium. Yilmaz et al (2016) studied 137 patients undergoing coronary FIGURE 5 | ROC curve analysis of potential CSF biomarker for differentiating the POD group from the Non-POD group. PE, phosphatidylethanolamine.…”

Section: Discussionmentioning

confidence: 99%

Metabolomic and Lipidomic Profiling of Preoperative CSF in Elderly Hip Fracture Patients With Postoperative Delirium

Han

Zhang

Liu

et al. 2020

Front. Aging Neurosci.

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Objective: To investigate dysregulated molecules in preoperative cerebrospinal fluid (CSF) of elderly hip fracture patients with postoperative delirium (POD), in order to identify potential pathological mechanisms and biomarkers for pre-stage POD. Materials and Methods: This nested case control study used untargeted metabolomic and lipidomic analysis to profile the preoperative CSF of patients (n = 40) who developed POD undergone hip fracture surgery (n = 10) and those who did not (n = 30). Thirty Non-POD patients were matched to 10 POD patients by age (± 2 years) and Mini Mental State Examination score (± 2 points). CSF was collected after successful spinal anesthesia and banked for subsequent analysis. On the first two postoperative days, patients were assessed twice daily using the Confusion Assessment Method-Chinese Revision. CSF samples from the two groups were analyzed to investigate possible relevant pathological mechanisms and identify candidate biomarkers. Results: Demographic characteristics of the groups were matched. Eighteen metabolites and thirty-three lipids were dysregulated in the preoperative CSF of POD patients. Pathway enrichment analysis revealed perturbations in D-glutamine and D-glutamate metabolism; glycerophospholipid metabolism; alanine, aspartate and glutamate metabolism; sphingolipid metabolism; histidine metabolism; and arginine biosynthesis at the pre-delirium stage. Receiver operating characteristic curve analysis indicated that phosphatidylethanolamine (PE, 40:7e), with an area under the curve value of 0.92, is a potential biomarker for POD. Conclusion: Multiple pathological mechanisms in the POD group were involved before surgery, including neuroinflammation, oxidative stress, and energy metabolism disorders induced by hypoxia, as well as neurotransmitter imbalances such as increased dopamine and glutamate, and decreased glutamine. These metabolic abnormalities potentially increase the fragility of the brain, thus contributing to POD. PE (40:7e) might

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Section: Discussionmentioning

confidence: 99%

Metabolomic and Lipidomic Profiling of Preoperative CSF in Elderly Hip Fracture Patients With Postoperative Delirium

Han

Zhang

Liu

et al. 2020

Front. Aging Neurosci.

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“…At the molecular level, delirium is thought to arise from a neurotransmitter imbalance leading to excess release of dopamine and reduced availability of acetylcholine [23]. This hypothesis is supported by epidemiological studies that have shown both anticholinergic medications and dopamine administration to be independent risk factors for the development of delirium [24,25]. Similarly, increases in other excitatory neurotransmitters such as glutamate and noradrenaline have been described, as well as variable alterations of gamma-amino-butyric acid (GABA), serotonin, and histamine, although evidence is conflicting or not well understood [26,27].…”

Section: Neurotransmitter Imbalancementioning

confidence: 99%

Epidemiology, Mechanisms, Diagnosis, and Treatment of Delirium: A Narrative Review

Ospina¹,

King²,

Madva³

et al. 2018

CMT

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“…However, elderly patients predispose to develop delirium after CABG (Deiner & Silverstein, ; Kobayashi et al, ; Loponen et al, ; Otomo, Maekawa, Goto, Baba, & Yoshitake, ; Smulter, Lingehall, Gustafson, Olofsson, & Engstrom, ). The incidence of postoperative delirium (POD) after CABG is 6% to 15% (Loponen et al, ; Yilmaz et al, ; W. Y. Zhang et al, ) in general and 46% to 73% (Khadka, McAlinden, & Pesudovs, ; Smith & Dimsdale, ) among patients aged 60 or older.…”

Section: Introductionmentioning

confidence: 99%

The quality of life of patients developed delirium after coronary artery bypass grafting is determined by cognitive function after discharge: A cross‐sectional study

Chen

Ding

Tao

et al. 2017

Int J of Nursing Practice

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Dopamine Administration is a Risk Factor for Delirium in Patients Undergoing Coronary Artery Bypass Surgery

Cited by 19 publications

References 20 publications

Metabolomic and Lipidomic Profiling of Preoperative CSF in Elderly Hip Fracture Patients With Postoperative Delirium

Metabolomic and Lipidomic Profiling of Preoperative CSF in Elderly Hip Fracture Patients With Postoperative Delirium

Epidemiology, Mechanisms, Diagnosis, and Treatment of Delirium: A Narrative Review

The quality of life of patients developed delirium after coronary artery bypass grafting is determined by cognitive function after discharge: A cross‐sectional study

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