Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery
Abstract Background: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the asso...
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Sociedade Brasileira de Anestesiologia
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| Series: | Revista Brasileira de Anestesiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200135&lng=en&tlng=en |
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| author | Eduardo Tobar Mario A. Abedrapo Jaime A. Godoy Jose L. Llanos Mauricio J. Díaz Rodrigo Azolas Gunther R. Bocic Jaime A. Escobar Rodrigo A. Cornejo Carlos M. Romero |
| author_facet | Eduardo Tobar Mario A. Abedrapo Jaime A. Godoy Jose L. Llanos Mauricio J. Díaz Rodrigo Azolas Gunther R. Bocic Jaime A. Escobar Rodrigo A. Cornejo Carlos M. Romero |
| author_sort | Eduardo Tobar |
| collection | DOAJ |
| description | Abstract Background: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. Methods: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery. Multimodal hemodynamic and perfusion variables were monitored, including central venous oxygenation (ScvO2), lactate levels, and non-invasive cerebral oxygenation (rSO2), according to a standard anesthesia protocol. Fisher's exact test or Student's t-test were used to compare patients who developed post-operative delirium with those who did not (p < 0.05). Results: We studied 28 patients, age 73 ± 7 years, 60.7% female. Two patients developed post-operative delirium (7.1%). These two patients had fewer years of education than those without delirium (p = 0.031). None of the peri-operative blood pressure variables were associated with incidence of post-operative delirium. In terms of perfusion parameters, postoperative ScvO2 was lower in the delirium than the non-delirium group, without reaching statistical significance (65 ± 10% vs. 74 ± 5%; p = 0.08), but the delta-ScvO2 (the difference between means post-operative and intra-operative) was associated with post-operative delirium (p = 0.043). Post-operative lactate and rSO2 variables were not associated with delirium. Conclusions: Our pilot study suggests an association between delta ScvO2 and post-operative delirium, and a tendency to lower post-operative ScvO2 in patients who developed delirium. Further studies are necessary to elucidate this association. |
| first_indexed | 2024-04-13T07:59:15Z |
| format | Article |
| id | doaj.art-8fb055deb66e4a0a89f5624bd3a98400 |
| institution | Directory Open Access Journal |
| issn | 1806-907X |
| language | English |
| last_indexed | 2024-04-13T07:59:15Z |
| publisher | Sociedade Brasileira de Anestesiologia |
| record_format | Article |
| series | Revista Brasileira de Anestesiologia |
| spelling | doaj.art-8fb055deb66e4a0a89f5624bd3a984002022-12-22T02:55:19ZengSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia1806-907X68213514110.1016/j.bjane.2017.10.003S0034-70942018000200135Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgeryEduardo TobarMario A. AbedrapoJaime A. GodoyJose L. LlanosMauricio J. DíazRodrigo AzolasGunther R. BocicJaime A. EscobarRodrigo A. CornejoCarlos M. RomeroAbstract Background: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. Methods: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery. Multimodal hemodynamic and perfusion variables were monitored, including central venous oxygenation (ScvO2), lactate levels, and non-invasive cerebral oxygenation (rSO2), according to a standard anesthesia protocol. Fisher's exact test or Student's t-test were used to compare patients who developed post-operative delirium with those who did not (p < 0.05). Results: We studied 28 patients, age 73 ± 7 years, 60.7% female. Two patients developed post-operative delirium (7.1%). These two patients had fewer years of education than those without delirium (p = 0.031). None of the peri-operative blood pressure variables were associated with incidence of post-operative delirium. In terms of perfusion parameters, postoperative ScvO2 was lower in the delirium than the non-delirium group, without reaching statistical significance (65 ± 10% vs. 74 ± 5%; p = 0.08), but the delta-ScvO2 (the difference between means post-operative and intra-operative) was associated with post-operative delirium (p = 0.043). Post-operative lactate and rSO2 variables were not associated with delirium. Conclusions: Our pilot study suggests an association between delta ScvO2 and post-operative delirium, and a tendency to lower post-operative ScvO2 in patients who developed delirium. Further studies are necessary to elucidate this association.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200135&lng=en&tlng=enDeliriumHypotensionGlobal perfusionCentral venous oxygen saturationLactateCerebral oxygenation |
| spellingShingle | Eduardo Tobar Mario A. Abedrapo Jaime A. Godoy Jose L. Llanos Mauricio J. Díaz Rodrigo Azolas Gunther R. Bocic Jaime A. Escobar Rodrigo A. Cornejo Carlos M. Romero Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery Revista Brasileira de Anestesiologia Delirium Hypotension Global perfusion Central venous oxygen saturation Lactate Cerebral oxygenation |
| title | Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery |
| title_full | Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery |
| title_fullStr | Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery |
| title_full_unstemmed | Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery |
| title_short | Impact of hypotension and global hypoperfusion in postoperative delirium: a pilot study in older adults undergoing open colon surgery |
| title_sort | impact of hypotension and global hypoperfusion in postoperative delirium a pilot study in older adults undergoing open colon surgery |
| topic | Delirium Hypotension Global perfusion Central venous oxygen saturation Lactate Cerebral oxygenation |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942018000200135&lng=en&tlng=en |
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