Postcardiotomy cognition

BACKGROUND: Agitation and delirium in critically ill patients after cardiac surgery carry poor in-hospital prognosis. Identifying risk factors may promote its prevention and management. Accordingly, this study aimed to evaluate the incidence of agitation and hyperactive delirium in postcardiotomy patients during the extracorporeal membrane oxygenation support and to identify the risk factors for its development. METHODS: This single center, retrospective study was conducted at Beijing Anzhen Hospital, Capital Medical University...

This article will briefly review the clinical studies focusing on measurement of serum levels of anticholinergic activity in delirious states. Three experimental approaches have been taken. First, to identify medications currently prescribed that have subtle anticholinergic effects. The current "list" includes 48 commonly prescribed medications. Second, to associate serum anticholinergic activity with delirium in various clinical states including postcardiotomy delirium, postelectroconvulsive delirium, delirious elderly medical inpatients, and nursing home patients...

The neurotransmitter acetylcholine has been implicated in animal and human studies of delirium. This chapter will briefly review the clinical studies focussing on measurement of serum levels of anticholinergic activity in delirious states. Three approaches have been taken. First, to identify medications currently prescribed that have subtle anticholinergic effects. The current 'list' includes 48 commonly prescribed medications. Second, to associate serum anticholinergic activity with delirium in various clinical states including postcardiotomy delirium, postelectroconvulsive delirium, delirious elderly medical inpatients, and nursing home patients...

This report details the implantation of a total artificial heart into a human being who survived for 112 days. Included are the criteria for candidate selection, the preoperative psychiatric evaluation, and the description of operative and postoperative complications in the context of the research subject's mental status over the period of his survival. Postmortem pathologic findings are reviewed. We summarize pertinent literature, including disordered behavior, postcardiotomy, and neuropsychiatric syndromes in hepatic, renal, and cardiac transplant patients...

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To examine the relationship between sleep loss and confusion after open-heart surgery, 27 consecutive patients were monitored 1 day preoperatively and 5 days postoperatively with the Folstein Mini-Mental State examination, a modified sleep latency test, and a sleep log. Confusion (low Mini-Mental State scores) peaked on postoperative Days 1 and 2 and correlated with insomnia (sleep time) during the following night but not during the preceding night. The results suggest that sleep loss is not the cause but, rather, a consequence of postcardiotomy confusion...

Critical care patients become confused in the intensive care setting. Several dangers exist in acute confusional states. Confused patients jeopardize their own safety, are more likely to die than nonconfused patients and are more likely to become cognitively impaired and require institutionalization. This article reviews the literature about patients experiencing acute confusional states in the critical care setting including intensive care unit (ICU) psychosis, postcardiotomy delirium and confusion in the elderly...