Organic mental disorders in cardiac surgery

Abstract

Organic mental disorders have been encountered throughout the history of cardiac surgery. They may occur either in association with neurological defects or as isolated phenomena. These disturbances have formerly been variously called “acute brain syndrome”, “toxic psychosis”, “metabolic encephalopathy”, “postoperative confusion state”, “postoperative behavioural disorder”, and “abnormal behavioural responses”. Although the nomenclature has been heterogenous and the criteria for defining the conditions have not been uniform, the disorders refer to disturbances attributable to organic causes interfering with normal brain function. Generally, these terms have been used to describe a condition which, according to the contemporary classification of mental disorders [1], is defined as delirium. However, the association of postoperative organic mental disorders with cardiac surgery is by no means unique: such disorders are also found for instance after eye surgery, e.g., in postoperative states which require patients to have their eyes closed for several days [2]. However, considering the very special conditions of cardiac patients during the early postoperative period, delirium is a problematic and potentially hazardous complication which needs recognition and treatment.