The Association of Perioperative Serum Lactate Levels with Postoperative Delirium in Elderly Trauma Patients

Lee, Cheol; Lee, Juhwan; Cho, Hyunho; Song, Jaekyeong; Jung, Hojung; Ma, Xiao; Hwang, Jihyo

doi:10.1155/2019/3963780

Cited by 8 publications

(9 citation statements)

References 34 publications

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“…Most models predicting mortality focused on short-term mortality, specifically happening while in the ICU 18,20,21,23,29,33,36,39,49,56 focused on prediction of in-hospital mortality 24,26,27,46 . Finally, Raj et al focused on the prediction of 30-day mortality 34 and Thoral et al on a composite outcome of in-hospital mortality and ICU readmission within 7 days of ICU discharge 37 .…”

Section: Mortalitymentioning

confidence: 99%

Dynamic Prediction of Patient Outcomes in the Intensive Care Unit: A Scoping Review of the State-of-the-Art

Lapp

Roper

Kavanagh

et al. 2023

J Intensive Care Med

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Introduction Intensive care units (ICUs) are high-pressure, complex, technology-intensive medical environments where patient physiological data are generated continuously. Due to the complexity of interpreting multiple signals at speed, there are substantial opportunities and significant potential benefits in providing ICU staff with additional decision support and predictive modeling tools that can support and aid decision-making in real-time. This scoping review aims to synthesize the state-of-the-art dynamic prediction models of patient outcomes developed for use in the ICU. We define “dynamic” models as those where predictions are regularly computed and updated over time in response to updated physiological signals. Methods Studies describing the development of predictive models for use in the ICU were searched, using PubMed. The studies were screened as per Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the data regarding predicted outcomes, methods used to develop the predictive models, preprocessing the data and dealing with missing values, and performance measures were extracted and analyzed. Results A total of n = 36 studies were included for synthesis in our review. The included studies focused on the prediction of various outcomes, including mortality (n = 17), sepsis-related complications (n = 12), cardiovascular complications (n = 5), and other complications (respiratory, renal complications, and bleeding, n = 5). The most common classification methods include logistic regression, random forest, support vector machine, and neural networks. Conclusion The included studies demonstrated that there is a strong interest in developing dynamic prediction models for various ICU patient outcomes. Most models reported focus on mortality. As such, the development of further models focusing on a range of other serious and well-defined complications—such as acute kidney injury—would be beneficial. Furthermore, studies should improve the reporting of key aspects of model development challenges.

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Section: Mortalitymentioning

confidence: 99%

Dynamic Prediction of Patient Outcomes in the Intensive Care Unit: A Scoping Review of the State-of-the-Art

Lapp

Roper

Kavanagh

et al. 2023

J Intensive Care Med

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show abstract

“…• Pol (nema dokaza da je muški pol veći faktor rizika kod kritično obolelih) uroloških i psihijatrijskih poremećaja, pre svega istorije cerebrovaskularnog insulta, epilepsije, demencije, kod apstinencije od alkohola i psihoaktivnih supstanci [10][11][12] . Depresija je identifikovana kao značajan faktor rizika za nastanak delirijuma kod pacijenata preko 65 godina i nakon kardiohirurških operacija 13 .…”

Section: Predisponirajući Faktoriunclassified

“…Malnutricija i neuhranjenost su udruženi sa oslabljenom imunološkom funkcijom organizma koja može da doprinese pojavi delirijuma 15 . Kod starih, nepokretnih pacijenata, najčešće prevedenih iz staračkih domova, dehidratacija, povišena vrednost uree i elektrolitni disbalans identifikovani su kao predisponirajući, ali i kao precipitirajući (triger) faktori za nastanak delirijuma [10][11][12] . Postoperativni delirijum može biti udružen sa perioperativnom hipotenzijom, hipoksemijom, anemijom, velikim intraoperativnim gubitkom krvi, dužinom trajanja operacije, značajnom postoperativnom transfuzijom, kao i niskim postoperativnim hematokritom.…”

Section: Predisponirajući Faktoriunclassified

“…Neadekvatna kontrola bola nakon traume, operacije ili invazivne procedure uzrokuje stres kod bolesnika, koji već dobro poznatim patofiziološkim mehanizmima dovodi do poremećaja spavanja, ima negativne efekte na imunitet i endokrini sistem, što se negativno odražava i na kognitivne funkcije. Jak bol, koji je nedovoljno kupiran analgeticima, značajno povećava rizik za nastanak delirijuma kod kognitivno očuvanih starijih pacijenata [8][9][10] . Prijem u JIL, okruženje koje često kod bolesnika izaziva neprijatnost, pa i panični napad, uz neadekvatno lečen bol i strah od invazivnih procedura i imobilizacije mogu da dovedu do razvoja teške anksioznosti.…”

Section: Predisponirajući Faktoriunclassified

“…To uslovljava poremećaj neurohumoralnog metabolizma i značajno doprinosi razvoju delirijuma 19 . Nekritična i preduga primena kontinuirane sedacije benzodijazepinima nesumnjivo je povezana sa produženim trajanjem delirijuma i lošijim ishodom 9,10 .…”

Section: Predisponirajući Faktoriunclassified

See 2 more Smart Citations

Delirium in the intensive care unit

Ratković¹,

Rajković²,

Hadžibegović³

et al. 2021

Serb J Anest Inten Therapy

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Delirium is not only a mental change but also a complex clinical syndrome with multiple pathophysiological changes. Delirium is an acute brain dysfunction accompanied by change or fluctuation of basal mental status, loss of attention with disorganized thinking, or altered level of consciousness. Although healthcare professionals realize the importance of recognizing delirium, it frequently goes unrecognized in the intensive care unit. Acute delirium is associated with increased mortality, morbidity, length of stay, and healthcare costs in intensive care units and hospitals. The consequences of delirium are long-term cognitive impairment, functional disability, post-discharge cognitive dysfunction, and institutionalization. Critical illness-related delirium can affect the diagnosis and treatment of primary diseases and disappears with the improvement of primary diseases. In the intensive care unit, delirium has been reported in 40% to 60% of non-ventilated patients and up to 50% to 80% of critically ill patients undergoing mechanical ventilation. Recent investigations have shown that delirium is preventable in 30-40% of cases. Available sedation and delirium monitoring instruments allow clinicians to recognize these forms of brain dysfunction. Multiple management strategies such as ABCDE, eCASH, and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.

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Progress in The Research of Lactate Metabolism Disruption And Astrocyte‐Neuron Lactate Shuttle Impairment in Schizophrenia: A Comprehensive Review

Zhang,

Tong,

et al. 2024

Advanced Biology

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Schizophrenia (SCZ) is a complex neuropsychiatric disorder widely recognized for its impaired bioenergy utilization. The astrocyte‐neuron lactate shuttle (ANLS) plays a critical role in brain energy supply. Recent studies have revealed abnormal lactate metabolism in SCZ, which is associated with mitochondrial dysfunction, tissue hypoxia, gastric acid retention, oxidative stress, neuroinflammation, abnormal brain iron metabolism, cerebral white matter hypermetabolic activity, and genetic susceptibility. Furthermore, astrocytes, neurons, and glutamate abnormalities are prevalent in SCZ with abnormal lactate metabolism, which are essential components for maintaining ANLS in the brain. Therefore, an in‐depth study of the pathophysiological mechanisms of ANLS in SCZ with abnormal lactate metabolism will contribute to a better understanding of the pathogenesis of SCZ and provide new ideas and approaches for the diagnosis and treatment of SCZ.

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The Association of Perioperative Serum Lactate Levels with Postoperative Delirium in Elderly Trauma Patients

Cited by 8 publications

References 34 publications

Dynamic Prediction of Patient Outcomes in the Intensive Care Unit: A Scoping Review of the State-of-the-Art

Dynamic Prediction of Patient Outcomes in the Intensive Care Unit: A Scoping Review of the State-of-the-Art

Delirium in the intensive care unit

Progress in The Research of Lactate Metabolism Disruption And Astrocyte‐Neuron Lactate Shuttle Impairment in Schizophrenia: A Comprehensive Review

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