Raised IL-2 and TNF-α concentrations are associated with postoperative delirium in patients undergoing coronary-artery bypass graft surgery

Kaźmierski, Jakub; Banyś, Andrzej; Latek, Joanna; Bourke, Julius; Jaszewski, Ryszard

doi:10.1017/s1041610213002378

Cited by 69 publications

(52 citation statements)

References 52 publications

(79 reference statements)

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“…Advances in CABG practice have improved the outcomes of patients; however, delirium remains a frequent postoperative complication. The reported incidence of delirium after CABG varies to a large extent, ranging between 10.5% and 50.6% [2][3][4][5]. The wide range of reported incidences could be explained by the differences in the number and characteristics of the studied populations, the design and methods of the studies, the assessment of delirium, the differences in cardiac operative procedure, and perioperative management.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative delirium in patients after coronary artery bypass grafting: A prospective cohort study

Zhang

et al. 2015

Journal of Critical Care

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Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative delirium in patients after coronary artery bypass grafting: A prospective cohort study

Zhang

et al. 2015

Journal of Critical Care

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“…Delirium was associated with elevated levels of pro-inflammatory markers such as inteleukin-8 (IL-8), and neuronspecific enolase. Kazmierski et al [25] conducted a prospective study enrolling 113 patients undergoing CABG surgery with CPB, investigating whether increased levels of IL-2 and TNF-α were associated with POD. An increased concentration of pro-inflammatory cytokines was independently associated with POD, and related to advancing age along with duration of CPB [25].…”

Section: Inflammation and Deliriummentioning

confidence: 99%

“…Kazmierski et al [25] conducted a prospective study enrolling 113 patients undergoing CABG surgery with CPB, investigating whether increased levels of IL-2 and TNF-α were associated with POD. An increased concentration of pro-inflammatory cytokines was independently associated with POD, and related to advancing age along with duration of CPB [25]. Peripheral cytokines can act directly through neurodegeneration, or indirectly through neurotransmission [26,27].…”

Section: Inflammation and Deliriummentioning

confidence: 99%

“…Interleukins in human and animal models have been demonstrated to induce symptoms of delirium, also mediating exotoxic neurodegeneration [28][29][30]. Cytokine dysregulation possibly causes neuronal injury through altered neurotransmission, apoptosis, and activation of brain immune cells which leads to production of free radicals, complement factors, and nitric oxide [25]. Cytokine dysregulation has been observed to be related with aging as well as infection, trauma and (surgical) stress [26].…”

Section: Inflammation and Deliriummentioning

confidence: 99%

“…Cytokine dysregulation has been observed to be related with aging as well as infection, trauma and (surgical) stress [26]. Therefore, the CPB-induced systemic inflammatory response should be considered as one of the most relevant determinants of POD, leading to and exacerbating the afore-mentioned neuroinflammation [25]. Cardiac surgery with CPB is associated with a profound systemic inflammatory response due to surgical trauma, and the interaction between blood and artificial circuit surfaces, leading to blood barrier dysfunction, cerebral inflammation, and glial cell injury [31,32].…”

Section: Inflammation and Deliriummentioning

confidence: 99%

See 2 more Smart Citations

Effects of statins on delirium following cardiac surgery – evidence from literature

Mariscalco¹,

Mariani²,

Biancari³

et al. 2015

Psychiatr Pol

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SummaryDelirium is a common complication after cardiac surgery, being associated with significant mortality and morbidity. The pathogenesis of postoperative delirium (POD) is complex and multifactorial, involving an interaction of multiple predisposing and precipitating factors. There are several hypotheses regarding the underlying mechanisms of POD, and the most recent emerging one involves neuroinflammation, which is exacerbated by the cardiopulmonary bypass-induced systemic inflammatory response. Experimental and clinical studies have recently documented improved perioperative central neural protection exerted by statins because of their anti-inflammatory, immunomodulatory, and antithrombotic properties. The present review will focused on the possible protective effect exerted by preoperative statin administration on delirium following cardiac surgery.

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Predisposing and Precipitating Factors Associated With Delirium

et al. 2023

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ImportanceDespite discrete etiologies leading to delirium, it is treated as a common end point in hospital and in clinical trials, and delirium research may be hampered by the attempt to treat all instances of delirium similarly, leaving delirium management as an unmet need. An individualized approach based on unique patterns of delirium pathophysiology, as reflected in predisposing factors and precipitants, may be necessary, but there exists no accepted method of grouping delirium into distinct etiologic subgroups.ObjectiveTo conduct a systematic review to identify potential predisposing and precipitating factors associated with delirium in adult patients agnostic to setting.Evidence ReviewA literature search was performed of PubMed, Embase, Web of Science, and PsycINFO from database inception to December 2021 using search Medical Subject Headings (MeSH) terms consciousness disorders, confusion, causality, and disease susceptibility, with constraints of cohort or case-control studies. Two reviewers selected studies that met the following criteria for inclusion: published in English, prospective cohort or case-control study, at least 50 participants, delirium assessment in person by a physician or trained research personnel using a reference standard, and results including a multivariable model to identify independent factors associated with delirium.FindingsA total of 315 studies were included with a mean (SD) Newcastle-Ottawa Scale score of 8.3 (0.8) out of 9. Across 101 144 patients (50 006 [50.0%] male and 49 766 [49.1%] female patients) represented (24 015 with delirium), studies reported 33 predisposing and 112 precipitating factors associated with delirium. There was a diversity of factors associated with delirium, with substantial physiological heterogeneity.Conclusions and RelevanceIn this systematic review, a comprehensive list of potential predisposing and precipitating factors associated with delirium was found across all clinical settings. These findings may be used to inform more precise study of delirium’s heterogeneous pathophysiology and treatment.

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Raised IL-2 and TNF-α concentrations are associated with postoperative delirium in patients undergoing coronary-artery bypass graft surgery

Cited by 69 publications

References 52 publications

Risk factors for postoperative delirium in patients after coronary artery bypass grafting: A prospective cohort study

Risk factors for postoperative delirium in patients after coronary artery bypass grafting: A prospective cohort study

Effects of statins on delirium following cardiac surgery – evidence from literature

Predisposing and Precipitating Factors Associated With Delirium

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