Abstract
Perioperative neurocognitive disorders remain a challenging obstacle in patients after cardiac surgery, as they significantly contribute to postoperative morbidity and mortality. Identifying the modifiable risk factors and mechanisms for postoperative cognitive decline (POCD) and delirium (POD) would be an important step forward in preventing such adverse events and thus improving patients’ outcome. Intraoperative hypotension is frequently discussed as a potential risk factor for neurocognitive decline, due to its significant impact on blood flow and tissue perfusion, however the studies exploring its association with POCD and POD are very heterogeneous and present divergent results. This review demonstrates 13 studies found after structured systematic search strategy and discusses the possible relationship between intraoperative hypotension and postoperative neuropsychiatric dysfunction.
Highlights
(POD) would be an important step forward in preventing such adverse events and improving patients’ outcome
Perioperative neurocognitive disorders include a variety of neuropsychiatric complications, amongst which postoperative delirium (POD) and postoperative neurocognitive disorder (POCD) are the most common and clinically important [1]
The term ‘perioperative neurocognitive disorders’ encompasses cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation; any form of acute event and cognitive
Summary
(POD) would be an important step forward in preventing such adverse events and improving patients’ outcome. According to the DSM-V criteria, POD is considered when disturbance of consciousness with reduced ability to focus, sustain and shift attention, and awareness, occurs. It has an acute onset and fluctuating course, usually is self-limiting and resolves within a few days after surgery. The term ‘perioperative neurocognitive disorders’ encompasses cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium, POD) and cognitive. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations
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