Impacto da hipotensão e hipoperfusão global sobre o delírio pós‐operatório: um estudo piloto com idosos submetidos à cirurgia aberta do cólon

Tobar, Eduardo; Abedrapo, Mario; Godoy, Jaime; Llanos, José Luis; Díaz, Mauricio J.; Azolas, Rodrigo; Bocic, Gunther; Escobar, Jaime A.; Cornejo, Rodrigo; Romero, Carlos

doi:10.1016/j.bjan.2017.10.002

Cited by 8 publications

(2 citation statements)

References 23 publications

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“…One participant in our study died (1.81%), though the immediate cause of death is not known. We also found a higher 30-day in-hospital mortality rate than that reported in Austria (0.10%)17 and the United States (0.66%).18 The patient who died developed intraoperative hypotension, which is a risk factor associated with POD6 after TURP.19 Brain hypoperfusion may explain this finding.20…”

Section: Discussionsupporting

confidence: 53%

<p>Functional capacity as a predictor of postoperative delirium in transurethral resection of prostate patients in Northeast Brazil</p>

Braga¹,

Castelo-Filho²,

Pinheiro³

et al. 2019

NDT

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IntroductionPostoperative delirium (POD) is a common disorder and its frequency varies from 15% to 25% after major elective surgery. There are few data on the incidence of POD in Brazil. Here, we sought to assess the incidence of POD following transurethral resection of the prostate (TURP) and to examine precipitating and predisposing factors associated.MethodWe performed a prospective observational study of elderly male patients undergoing TURP (N=55) in Northeast Brazil. Information on demographic, medical, cognitive and functional characteristics were collected. The participants were followed until hospital discharge. POD was diagnosed by the Confusion Assessment Method.ResultsA total of three participants (5.45%) were identified with POD. Episodes of delirium lasted 3±1 days. The study sample consisted of a healthy population. Patients with POD had longer hospital stay and more precipitating factors. The POD group showed statistically significant lower Barthel index score (p<0.001) and higher Pfeffer’s Functional Activities Questionnaire scores (p<0.01).ConclusionLoss of functional capacity was associated with POD in a healthy population of elderly patients undergoing TURP.

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Section: Discussionsupporting

confidence: 53%

<p>Functional capacity as a predictor of postoperative delirium in transurethral resection of prostate patients in Northeast Brazil</p>

Braga¹,

Castelo-Filho²,

Pinheiro³

et al. 2019

NDT

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“…Another limitation is the low incidence of PD in our patient sample (6.7%) compare to the reported incidence, which is nearly 20% in patients with similar characteristics. In our hospital, the incidence of PD is usually low (Gutierrez et al, 2018; Tobar et al, 2018), as confirmed by twice-daily CAM evaluation by a professional team. The main factors could be the following: benzodiazepines are not used, non-pharmacological preventive measures of PD are applied during all perioperative process as a clinical standard, patients who attend our hospital have in general a high level of education, and the lack of inter-reliability was not assessed across the occupational therapists, among others.…”

Section: Discussionmentioning

confidence: 53%

Intraoperative Low Alpha Power in the Electroencephalogram Is Associated With Postoperative Subsyndromal Delirium

Gutiérrez

Egaña

Saez

et al. 2019

Front. Syst. Neurosci.

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BackgroundPostoperative delirium (PD) and subsyndromal delirium (PSSD) are frequent complications in older patients associated with poor long-term outcome. It has been suggested that certain electroencephalogram features may be capable of identifying patients at risk during surgery. Thus, the goal of this study was to characterize intraoperative electroencephalographic markers to identify patients prone to develop PD or PSSD.MethodsWe conducted an exploratory observational study in older patients scheduled for elective major abdominal surgery. Intraoperative 16 channels electroencephalogram was recorded, and PD/PSSD were diagnosed after surgery with the confusion assessment method (CAM). The total power spectra and relative power of alpha band were calculated.ResultsPD was diagnosed in 2 patients (6.7%), and 11 patients (36.7%) developed PSSD. All of them (13 patients, PD/PSSD group) were compared with patients without any alterations in CAM (17 patients, control group). There were no detectable power spectrum differences before anesthesia between both groups of patients. However, PD/PSSD group in comparison with control group had a lower intraoperative absolute alpha power during anesthesia (4.4 ± 3.8 dB vs. 9.6 ± 3.2 dB, p = 0.0004) and a lower relative alpha power (0.09 ± 0.06 vs. 0.21 ± 0.08, p < 0.0001). These differences were independent of the anesthetic dose. Finally, relative alpha power had a good ability to identify patients with CAM alterations in the ROC analysis (area under the curve 0.90 (CI 0.78-1), p < 0.001).DiscussionIn conclusion, a low intraoperative alpha power is a novel electroencephalogram marker to identify patients who will develop alterations in CAM – i.e., with PD or PSSD – after surgery.

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

Tobar

Cornejo

Godoy

et al. 2021

Brazilian Journal of Anesthesiology (English Edition)

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Impacto da hipotensão e hipoperfusão global sobre o delírio pós‐operatório: um estudo piloto com idosos submetidos à cirurgia aberta do cólon

Abstract: Our pilot study suggests an association between delta ScvO and post-operative delirium, and a tendency to lower post-operative ScvO in patients who developed delirium. Further studies are necessary to elucidate this association.

Cited by 8 publications

References 23 publications

<p>Functional capacity as a predictor of postoperative delirium in transurethral resection of prostate patients in Northeast Brazil</p>

<p>Functional capacity as a predictor of postoperative delirium in transurethral resection of prostate patients in Northeast Brazil</p>

Intraoperative Low Alpha Power in the Electroencephalogram Is Associated With Postoperative Subsyndromal Delirium

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

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