Professional exposure and environmental pollution for sevofluroane, in postoperative units, during inhalatory sedation with the conservative device of anesthesia (AnaConDa®)

Abstract

Results and Discussion: Delirium occurred in 29 patients (15%). Before surgery 8% and 20% of patients were dependent in at least one activity in instrumental and personal ADL, respectively. Patients dependent in at least one ADL had more frequently delirium after surgery (31 % versus 11%, p=0.004) but mortality and length of hospital and PACU stay was not higher from other patients with no dependency in ADL. Patients with postoperative delirium had worse scores in three SF-36 domains before surgery: physical function (p<0.001), bodily pain (p=0.011) and social functioning (p=0.045). Conclusion(s):This study shows that patients with dependency in ADL have more frequently delirium after surgery. Patients that develop delirium after surgery had worse scores in some SF-36 domains.Background and Goal of Study: Delirium is a common, probably underdiagnosed, complication following cardiac surgery and is associated with increased morbidity, mortality and costs. There is no optimal regime defined for its treatment. The goal of our audit was to look at incidence, risk factors, implications and treatment of delirium in the cardiac ICU. Materials and Methods: We retrospectively audited 101 consecutive patients, aged 66 (11) in the period of January to July 2009. We collected data on: delirium score (ICDSC-Intensive Care delirium screening checklist), past-medical history, pre-op medications, CPB time, X-clamp time, circulatory arrest time, type of operation, consequences and treatment received. The statistical tests used were chi-squared test with continuity correction for nominal categorical data and logistic regression for continuous data. Results and Discussion: 26/101 (26%) patients developed delirium, defined as delirium score ICDSC of 4 or more. Data in Table 1 are number (%) or mean (SD). The most common implications secondary to delirium were noncompliance with oxygen therapy 20/26 (76%) and medications 15/26(57%), removal of lines 10/26 (38.4%), drains 2/26 (7.7%) and assault to the ICU staff 3/26(11.5%). There was no consistency in treatment and no regular medication regime following an episode of delirium. 21/26 of patients received pharmacological treatment. Our study may be too small to show any other risk factors for developing delirium.