Cognitive Dysfunction, Delirium, and Stroke in Cardiac Surgery Patients

Semin Cardiothorac Vasc Anesth. 2015 Dec;19(4):309-17. doi: 10.1177/1089253215570062.

Abstract

Neurologic injury in the form of cognitive decline, delirium, and stroke are common phenomena in patients undergoing cardiac surgery and continues to be one of the most common complication after cardiac surgery, in spite of improvements in mortality and and improved surgical and anesthetic techniques. These complications lead to a significant increase in length of stay in the intensive care unit, increased length of hospital admission, and functional impairment, resulting in not only profound negative effects on patients who experience these complications, but also to increased costs of medical care and delivery. We discuss each of these complications in regard to their risks factors, incidence, potential therapeutic modalities, and relevant intraoperative and postoperative considerations.

Keywords: brain injury; cardiac anesthesia; cardiac surgery; cardiopulmonary bypass surgery; cerebral metabolism; critical care; elderly patients; inflammation; near-infrared spectroscopy.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Cognition Disorders / epidemiology
  • Cognition Disorders / etiology*
  • Delirium / epidemiology
  • Delirium / etiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Intensive Care Units
  • Length of Stay
  • Postoperative Complications / epidemiology
  • Risk Factors
  • Stroke / epidemiology
  • Stroke / etiology*