Effects of dexmedetomidine on postoperative cognitive function in patients undergoing coronary artery bypass grafting

Gong, Zheng; Li, Jun; Zhong, Yuan; Guan, Xue-Hai; Huang, Ailan; Ma, Li

doi:10.3892/etm.2018.6778

Cited by 21 publications

(52 citation statements)

References 20 publications

(19 reference statements)

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“…POCD is one of the most common complications after CABG and is mainly manifested as impairment of memory ability, abstraction ability, mental concentration, and knowledge analysis and applying ability, which seriously interferes with the rehabilitation and prognosis of coronary heart disease patients after CABG. As reported, POCD occurs in 65% of patients discharged after CABG surgery and in ∼40% in the months following surgery on average [22]. The 21-day POCD incidence of 27.1% in the present study is similar with previous reports [23][24][25].…”

Section: Discussionsupporting

confidence: 91%

Preoperative red cell distribution width predicts postoperative cognitive dysfunction after coronary artery bypass grafting

Wan

Luo

et al. 2020

Bioscience Reports

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We assessed the relationship between red blodd cell distribution width (RDW) and postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG) in patients who usually had obvious hemodynamic changes. We enrolled 362 coronary heart disease patients who received CABG. POCD was assessed through neuropsychological examination at 21 days after operation. Demographics, history of diseases, blood biochemical parameters and perioperative data were collected. The receiver operating characteristic (ROC) curve was used to find the best cut-off value of RDW for diagnosis of POCD. Logistic regression was used to explore the relationship between RDW and POCD. The 21-day incidence of POCD in patients receiving CABG was 27.1% (98/362). The RDW of POCD patients was significantly higher than in the non-POCD patients (17.4 vs. 13.2). The sensitivity and specificity of RDW for predicting POCD were 82.7 and 64.8%, respectively. The POCD patients also tended to be older and had higher fasting plasma glucose, hypersensitive c-reactive protein, tumor necrosis factor-α, white blood cell levels and longer surgery time. No significant differences were found in other parameters. The 21-day neuropsychological test results were better in the POCD patients than the non-POCD patients. After adjustment of potential factors, the preoperative high RDW was still associated with an increased risk of POCD (odds ratio (OR) = 2.52, 95% confidence interval (CI): 1.28–4.31). Our study indicates that preoperative RDW is significantly elevated in POCD patients receiving CABG. The elevated preoperative RDW is associated with an increased risk of POCD and preoperative RDW can be an independent predictor of POCD.

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Section: Discussionsupporting

confidence: 91%

Preoperative red cell distribution width predicts postoperative cognitive dysfunction after coronary artery bypass grafting

Wan

Luo

et al. 2020

Bioscience Reports

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“…In spite of many reports indicated that Dex exerted a protective effect of the nervous system via inhibiting inflammatory response,20,21 little is known about the relationship of Dex and NF-κB pathway. In addition, previous study reported that POCD was associated with microRNAs (miRNAs) 22.…”

Section: Introductionmentioning

confidence: 99%

<p>Dexmedetomidine Attenuates Neuroinflammation In LPS-Stimulated BV2 Microglia Cells Through Upregulation Of miR-340</p>

Yang

Zhu

et al. 2019

DDDT

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BackgroundDexmedetomidine (Dex) was reported to exhibit anti-inflammatory effect in the nervous system. However, the mechanism by which Dex exhibits anti-inflammation effects on LPS-stimulated BV2 microglia cells remains unclear. Thus, this study aimed to investigate the role of Dex in LPS-stimulated BV2 cells.MethodsThe BV2 cells were stimulated by lipopolysaccharides (LPS). BV2 cells were infected with short-hairpin RNAs targeting NF-κB (NF-κB-shRNAs) and NF-κB overexpression lentivirus, respectively. In addition, miR-340 mimics or miR-340 inhibitor was transfected into BV2 cells, respectively. Meanwhile, the dual-luciferase reporter system assay was used to explore the interaction of miR-340 and NF-κB in BV2 cells. CCK-8 was used to detect the viability of BV2 cells. In addition, Western blotting was used to detect the level of NF-κB in LPS-stimulated BV2 cells. The levels of TNF-α, IL-6, IL-1β, IL-2, IL-12, IL-10 and MCP-1 in LPS-stimulated BV2 cells were measured with ELISA.ResultsThe level of miR-340 was significantly upregulated in Dex-treated BV2 cells. Meanwhile, the level of NF-κB was significantly increased in BV2 cells following infection with lenti-NF-κB, which was markedly reversed by Dex. LPS markedly increased the expression of NF-κB and proinflammatory cytokines in BV2 cells, which were reversed in the presence of Dex. Moreover, miR-340 mimics enhanced the anti-inflammatory effects of Dex in LPS-stimulated BV2 cells via inhibiting NF-κB and proinflammatory cytokines. Furthermore, Dex obviously inhibited LPS-induced phagocytosis in BV2 cells.ConclusionTaken together, our results suggested that Dex might exert anti-inflammatory effects in LPS-stimulated BV2 cells via upregulation of miR-340. Therefore, Dex might serve as a potential agent for the treatment of neuroinflammation.

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“…To determine the required sample size, the following criteria were taken into consideration: level = 0.05 (two-sided); statistical power = 0.8; proportion of cognitive dysfunction in control group = 35%; the estimated incidence of cognitive dysfunction in CABG group = 65% thus the required sample size was 102 (51 in each group). To accommodate an expected 10% dropout or lost to follow-up rate, the final enrollment was 112 patients [ 15 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study

et al. 2021

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To find out risk factors for postoperative cognitive dysfunction (POCD) after coronary artery bypass grafting (CABG), and to provide basis for clinically prevention of POCD. A total of 88 patients underwent CABG were surveyed with Telephone Questionnaire (TICS-M) for their cognitive impairment after 3, 7, 21, 90, 180d surgery. The occurrence of POCD was diagnosed by Neuropsychological Battery which including Vocabular Learning Test (VLT), Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT). The preoperative, intraoperative and postoperative risk factors were assessed by the χ2 or t test. Multivariate analysis was used to study the correlation between the risk factors and the occurrence of POCD. Age, aortic plaque, carotid artery stenosis, cerebrovascular disease, anesthesia time, the rate of decline in intraoperative hemoglobin concentration (ΔHb) and systemic inflammatory response syndrome (SIRS) score on postoperative 2d have significant statistically (P < 0.05) influence on the occurrence of POCD. Aortic plaque, carotid artery stenosis, anesthesia time and SIRS score (OR value > 1, P < 0.05) are risk factors for POCD. The incidence of 21d and 180d POCD was approximately 26.1 % and 22.7 %, respectively.

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Effects of dexmedetomidine on postoperative cognitive function in patients undergoing coronary artery bypass grafting

Cited by 21 publications

References 20 publications

Preoperative red cell distribution width predicts postoperative cognitive dysfunction after coronary artery bypass grafting

Preoperative red cell distribution width predicts postoperative cognitive dysfunction after coronary artery bypass grafting

<p>Dexmedetomidine Attenuates Neuroinflammation In LPS-Stimulated BV2 Microglia Cells Through Upregulation Of miR-340</p>

Assessment of risk factors for postoperative cognitive dysfunction after coronary artery bypass surgery: a single-center retrospective cohort study

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