• Nina Smulter, Helena Claesson Lingehall, Yngve Gustafson, Birgitta Olofsson, Karl Gunnar Engström, Micael Appelblad, and Staffan Svenmarker.
• Department of Surgery and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden; Department of Nursing, Umeå University, Umeå, Sweden. Electronic address: nina.smulter@umu.se.
• J. Cardiothorac. Vasc. Anesth. 2018 Apr 1; 32 (2): 684-690.

ObjectiveThe aim of this study was to determine risk factors for postoperative delirium after cardiac surgery, specifically associated with the conduct of cardiopulmonary bypass (CPB).DesignProspective observational study.SettingHeart Centre, University Hospital.ParticipantsThe study included 142 patients aged 70 years and older scheduled for elective cardiac surgery with CPB.InterventionsRisk factor analysis comprised information collected from the hospital clinical and CPB dedicated databases in addition to the medical chart. Delirium was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision criterion using the Mini Mental State Examination and the Organic Brain Syndrome scale.Measurements And Main ResultsAssessments of delirium diagnosis were executed preoperatively and on the following first and fourth postoperative days. Delirium occurred in 55% (78/142) of the patients. Patients with delirium were identified with significantly higher body weight and body surface area preoperatively, accompanied with longer CPB time, higher positive fluid balance per CPB, and lower systemic pump flow related to body surface area. Furthermore, the duration of the mixed venous oxygen saturation (SvO2) below 75% was significantly longer during CPB. The result from the multivariable logistic regression analysis included the duration of SvO2 below 75%, fluid balance per CPB and patient age as independent risk factors for postoperative delirium.ConclusionsThe influence of the SvO2 level during CPB, fluid balance, and patient age should be recognized as risk factors for postoperative delirium after cardiac surgery in patients 70 years and older.Copyright © 2017 Elsevier Inc. All rights reserved.

26 keywords...

hide…