Dynamic Change of Lymphocyte-to-Monocyte Is Associated With the Occurrence of POCD After Cardiovascular Surgery: A Prospective Observational Study

Zhao, Qi; Gao, Rui; Liu, Changliang; Chen, Hai; Zhang, Xueying; Guan, Jian; Xie, Xiaoyu; Qiu, Yanhua; Xu, Cheng; Lv, Ping; Zhu, Tao; Chen, Chan

doi:10.3389/fnbeh.2021.646528

Cited by 9 publications

(19 citation statements)

References 37 publications

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“…On the other hand, anesthesia may harm cognitive function by different drugs, methods, and depth [ 54 – 56 ]. In addition, the scores of PND patients were mainly decreased in word short-term recall, delayed recall, and delayed interference tests, indicating their neurocognitive damage were basically in aspects of short-term and delayed memory, almost consistent with that of the previous study [ 2 ]. Besides, we compared the baseline information and blood examinations between the mild PND group and severe PND group that no significant difference was displayed.…”

Section: Discussionsupporting

confidence: 88%

“…This concept combines the postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). At the same time, POD is defined as an acute disorder of attention and cognition after surgery, and POCD used to be a concept but not a clinical diagnosis, representing a significant decline in neurocognitive performance in attention, orientation, memory, verbal fluency, coordination and so on [ 2 , 3 ]. PND has been proved to increase the cost of care, reduce the quality of life, increase the risk of long-term cognitive decline and mortality [ 4 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Perioperative platelet count in peripheral blood is associated with the early stage of PND after major orthopedic surgery: a prospective observational study

et al. 2022

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Background Perioperative neurocognitive disorders (PND) are common complications of major surgery among elderly patients, remarkably decreasing patients’ life quality. Platelet count has been proved to be an essential factor in inflammation. However, as far as we know, the relationship between platelet count and PND is not clear yet in the orthopedic area. PND could be a long-term disease, which sometimes lasts for several years, and it is meaningful to find a biomarker of PND at the early stage. Thus, we designed this study to find out the association between perioperative platelet count and occurrence of PND, and determine whether preoperative platelet count could be a biomarker of the early stage of PND. Methods A prospective observational study was performed on the patients who would take total knee arthroplasty or total hip arthroplasty. Their peripheral platelets were counted by blood routine examination 1 day before and 3 days after the surgery. And we assessed their neurocognitive functions 1 day before and 3 days after the surgery. These data were recorded and analyzed to find out the relationship between platelet count and the occurrence of PND. Results Eventually, 70 patients finished the whole process, and 14 of them developed PND. The median preoperative platelet count in the PND group was significantly higher than that in the non-PND group (239 vs 168 × 10^9/L, p = 0.009). Preoperative platelet count was an independent risk factor for PND (odds ratio = 1.014, 95% confidence interval [CI] 1.000–1.027, P = 0.043) in the logistic multivariable regression, while the area under the curve of the receiver operating characteristic curve of the prediction model was 0.796 (95% CI 0.676–0.916). Conclusions The higher preoperative and postoperative level of platelet count in the peripheral blood were associated with the early stage of PND, and preoperative platelet count could be a potential predictor of the early stage of PND in patients undergoing major orthopedic surgeries. Trial registration Chinese Clinical Trial Registry: ChiCTR2000033001, registration date: 17 May 2020.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Perioperative platelet count in peripheral blood is associated with the early stage of PND after major orthopedic surgery: a prospective observational study

et al. 2022

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“…Also, most of the studies investigated POCD over a very short period of time (such as 3, 5, 6 and 7 days after surgery). 23,25,28,[32][33][34]37,40,41 Therefore, the results may be directly affected by practice effects, medications (such as opioids), symptoms such as pain and other acute mental conditions such as delirium. Only two studies 21,33 reported postoperative delirium, and just one 21 reported that delirium is a risk factor for POCD.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies excluded females only. 20,21 Regarding the type of surgery, 17 studies (73.9%) reported openheart cardiopulmonary bypass (CPB), [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] two studies (8.6%) noted off-pump coronary artery bypass (OPCAB) 37,38 and two studies (8.6%) reported both OPCAB and CPB. 20,29 Two studies (8.6%) did not report the type of surgical technique.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Anaesthesia‐related cognitive dysfunction following cardiothoracic surgery in late middle‐age and younger adults: A scoping review

Varpaei,

Robbins,

Ling

et al. 2023

Nursing in Critical Care

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AimThis review aimed to evaluate factors associated with anaesthesia‐related postoperative cognitive dysfunction (POCD) among adults younger than 65 years who underwent cardiothoracic surgeries.Study DesignA systematic keyword search, following the scoping review framework, was performed in the PubMed and CINAHL databases. Original English‐language studies that included adults younger than 65 years and addressed cognitive function after surgery along with anaesthesia management were included. Retrospective studies, animal research and in vitro and in vivo studies were excluded.ResultsTwenty‐three articles were included (65.2% interventional studies). All studies lacked theoretical or conceptual frameworks. Ketamine's neuroprotective potential is questionable, and intravenous lidocaine may be considered a possible early agent for preventing POCD, but long‐term effectiveness is uncertain. Compared to inhalational anaesthesia, total intravenous anaesthesia (TIVA) may be related to a decreased incidence of POCD. Variation in POCD assessment impacted the lack of homogeneity in obtained data. Moreover, the shorter‐term timing of POCD evaluation such as in early days after surgery could be greatly influenced by medication and delirium.ConclusionAlthough strategies such as TIVA, the use of neuroprotective anaesthetics and comprehensive preoperative assessments are suggested to prevent POCD, this multifactorial phenomenon cannot be explicitly attributed solely to anaesthetics or anaesthesia‐related techniques. Use of standardized, reliable and valid tools for POCD assessment is encouraged for cross‐study comparison.Relevance to Clinical PracticeNurses and certified nurse anaesthetists must be aware of risk factors for postoperative delirium and POCD so they can assess patients before and after surgery. Patients and caregivers need to be educated about cognitive changes after surgery and advised to report them to their health care provider if they occur.

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“…Общая анестезия, по сравнению с регионарной (либо сочетанной), существенно повышает риск когнитивных нарушений [35,36]. Значительно возрастает риск развития когнитивных нарушений при реконструктивной сосудистой хирургии сонных артерий, кардиохирургии [37], особенно с использованием искусственного кровообращения. В исследованиях Т. В. Клыпа [38,39] показано развитие нейрокогнитивных нарушений различной степени тяжести у 30-70% больных после кардиохирургических вмешательств.…”

Section: этиологияunclassified

Etiology and Pathogenesis of Postoperative Cognitive Dysfunction (Review)

Неймарк

Shmelev

Rakhmonov

et al. 2023

Obŝaâ reanimatologiâ

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Impairment of higher mental functions can complicate the course of the postoperative period even after short and minimally invasive, including laparoscopic, surgical procedures. Postoperative cognitive dysfunction signiﬁcantly challenges patients’ quality of life, negating real success of surgical intervention and anesthetic support. In some cases, early postoperative cognitive dysfunction may be one of the main predictors of persistent cognitive impairment.The purpose of the review. To contemplate etiology, pathogenesis and the current perspective of postoperative cognitive dysfunction.We analyzed 96 publications in various databases (PubMed, Medline, RSCI and others), including 67 papers published over the past 5 years.The review provides an overview of current deﬁnitions and classiﬁcation of postoperative cognitive dysfunction, data on the prevalence, polyethyology and risk factors, potential impact of the type of anesthesia and surgical intervention on the development of postoperative cognitive dysfunction. Various pathogenetic mechanisms of higher mental functions impairment alongside with available eﬀective pharmacotherapies to correct them were considered.Conclusion. Numerous adverse factors of the perioperative period, such as neurotoxic eﬀects of general anesthetics, neuroinﬂammation in response to operational stress and surgical trauma, impaired autoregulation of the cerebral blood ﬂow, imperfect oxygen homeostasis, interactions of neurotransmitter, etc., can potentially cause postoperative cognitive dysfunction. Further deeper insights into etiology and pathogenesis of early postoperative cognitive dysfunction are relevant and necessary to improve prevention strategies and identify most eﬀective pharmacotherapies to correct such disorders.

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Dynamic Change of Lymphocyte-to-Monocyte Is Associated With the Occurrence of POCD After Cardiovascular Surgery: A Prospective Observational Study

Cited by 9 publications

References 37 publications

Perioperative platelet count in peripheral blood is associated with the early stage of PND after major orthopedic surgery: a prospective observational study

Perioperative platelet count in peripheral blood is associated with the early stage of PND after major orthopedic surgery: a prospective observational study

Anaesthesia‐related cognitive dysfunction following cardiothoracic surgery in late middle‐age and younger adults: A scoping review

Etiology and Pathogenesis of Postoperative Cognitive Dysfunction (Review)

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