Research Progress on Coping Strategies of Cognitive Impairment after Cardiac Surgery: A Systematic Review of Literature
Keywords:Postoperative cognitive dysfunction, central nervous system, coping strategies, preventive measures
Postoperative cognitive dysfunction (POCD) refers to a complication of neurological dysfunction after surgery, including one or more changes that are significantly lower than those before surgery. The purpose of this study was to review the coping strategies and risk factors of POCD.A systemic research was conducted searching Pubmed, web of science, MEDLINE and other websites with the keywords of cardiac surgery, cognitive impairment and POCD. Multiple factors have been associated with the treatment of POCD, including anesthetic, choice of analgesic drugs, anti-inflammatory drugs, erythropoietin, atherosclerosis, emotional factors, surgical and other factors. Targeted treatments are carried out for risk factors that may affect POCD prevention, such as anesthetic drug prevention, anti-inflammatory drug prevention, and intraoperative prevention and other preventive measures are aimed at reducing the incidence of POCD after cardiac surgery
Baki ED, Aldemir M, Kokulu S, et al. 2013. Comparison of the effects of desflurane and propofol anesthesia on the inflammatory response and s100β protein during coronary artery bypass grafting. Inflammation. 36(6):1327-1333.
Bartels K, McDonagh DL, Newman MF, Mathew JP. 2013. Neurocognitive outcomes after cardiac surgery. Curr Opin Anaesthesiol. 26(1):91-97.
Bhushan S, Huang X, Li Y, et al. 2021. Paravalvular Leak After Transcatheter Aortic Valve Implantation Its Incidence, Diagnosis, Clinical Implications, Prevention, Management, and Future Perspectives: A Review Article [published online ahead of print, 2021 Aug 5]. Curr Probl Cardiol. 100957.
Bhushan S, Li Y, Huang X, Han C, Ke G, Zongwei X. 2021. Progress of research in postoperative cognitive dysfunction in cardiac surgery patients: A review article. Int J of Surg. 95. 106163.
Boodhwani M, Rubens F, Wozny D, Rodriguez R, Nathan HJ. 2007. Effects of sustained mild hypothermia on neurocognitive function after coronary artery bypass surgery: a randomized, double-blind study. J Thorac Cardiovasc Surg. 134(6):1443-1452.
Bruggemans EF. 2013. Cognitive dysfunction after cardiac surgery: Pathophysiological mechanisms and preventive strategies. Neth Heart J. 21(2):70-73
Charlson ME, Peterson JC, Krieger KH, et al. 2007. Improvement of outcomes after coronary artery bypass II: a randomized trial comparing intraoperative high versus customized mean arterial pressure. J Card Surg. 22(6):465-472.
Dávila-Román VG, Murphy SF, Nickerson NJ, Kouchoukos NT, Schechtman KB, Barzilai B. 1999. Atherosclerosis of the ascending aorta is an independent predictor of long-term neurologic events and mortality. J Am Coll Cardiol. 33(5):1308-1316.
Evered LA, Silbert BS, Scott DA. 2010. Postoperative cognitive dysfunction and aortic atheroma. Ann Thorac Surg. 89(4):1091-1097.
Fang Q, Qian X, An J, Wen H, Cope DK, Williams JP. 2014. Higher dose dexamethasone increases early postoperative cognitive dysfunction. J Neurosurg Anesthesiol. 26(3):220-225.
Fong HK, Sands LP, Leung JM. 2006. The role of postoperative analgesia in delirium and cognitive decline in elderly patients: a systematic review. Anesth Analg. 102(4):1255-1266.
Gantner DC, Bailey M, Presneill J, et al. 2018. Erythropoietin to Reduce Mortality in Traumatic Brain Injury: A Post-hoc Dose-effect Analysis. Ann Surg. 267(3):585-589.
Glumac S, Kardum G, Sodic L, Supe-Domic D, Karanovic N. 2017. Effects of dexamethasone on early cognitive decline after cardiac surgery: A randomised controlled trial. Eur J Anaesthesiol. 34(11):776-784.
Goto T, Maekawa K. 2014. Cerebral dysfunction after coronary artery bypass surgery. J Anesth. 28(2):242-248.
Grigore AM, Grocott HP, Mathew JP, et al. 2002. The rewarming rate and increased peak temperature alter neurocognitive outcome after cardiac surgery. Anesth Analg. 94(1).
Hemmerling TM, Minardi C, Zaouter C, Noiseux N, Prieto I. 2010. Sevoflurane causes less arrhythmias than desflurane after off-pump coronary artery bypass grafting: a pilot study. Ann Card Anaesth. 13(2):116-122.
Hiraoka K, Kawatsu S, Mori E, Saiki Y. 2012. Total aortic arch replacement using hypothermic circulatory arrest with antegrade selective cerebral perfusion: are there cerebral deficits other than frank stroke?. Gen Thorac Cardiovasc Surg. 60(6):345-349.
Hogue CW Jr, Palin CA, Arrowsmith JE. 2006. Cardiopulmonary bypass management and neurologic outcomes: an evidence-based appraisal of current practices. Anesth Analg. 103(1):21-37.
Hori D, Everett AD, Lee JK, et al. 2015. Rewarming Rate During Cardiopulmonary Bypass Is Associated With Release of Glial Fibrillary Acidic Protein. Ann Thorac Surg. 100(4):1353-1358.
Hudetz JA, Patterson KM, Byrne AJ, et al. 2009. A history of alcohol dependence increases the incidence and severity of postoperative cognitive dysfunction in cardiac surgical patients. Int J Environ Res Public Health. 6(11):2725-2739.
Jin Z, Hu J, Ma D. 2020. Postoperative delirium: perioperative assessment, risk reduction, and management. Br J Anaesth. 125(4):492-504.
Joshi B, Brady K, Lee J, et al. 2010. Impaired autoregulation of cerebral blood flow during rewarming from hypothermic cardiopulmonary bypass and its potential association with stroke. Anesth Analg. 110(2):321-328.
Kiviniemi T, Malmberg M, Biancari F, et al. 2018. Thromboembolisms related to post-operative electrical cardioversions for atrial fibrillation in patients with surgical aortic valve replacement. Eur Heart J Qual Care Clin Outcomes. 4(2):120-125.
Leng T, Gao X, Dilger JP, Lin J. 2016. Neuroprotective effect of lidocaine: is there clinical potential? Int J Physiol Pathophysiol Pharmacol. 8(1):9-13. Published Apr 25.
Liu YH, Wang DX, Li LH, et al. 2009. The effects of cardiopulmonary bypass on the number of cerebral microemboli and the incidence of cognitive dysfunction after coronary artery bypass graft surgery. Anesth Analg. 109(4):1013-1022.
Ostrowski D, Heinrich R. 2018. Alternative Erythropoietin Receptors in the Nervous System. J Clin Med. 7(2):24. Published Feb 2.
Riedel B, Browne K, Silbert B. 2014. Cerebral protection: inflammation, endothelial dysfunction, and postoperative cognitive dysfunction. Curr Opin Anaesthesiol. 27(1):89-97.
Sayed S, Idriss NK, Sayyedf HG, et al. 2015. Effects of propofol and isoflurane on haemodynamics and the inflammatory response in cardiopulmonary bypass surgery. Br J Biomed Sci. 72(3):93-101.
Schoen J, Husemann L, Tiemeyer C, et al. 2011. Cognitive function after sevoflurane- vs propofol-based anaesthesia for on-pump cardiac surgery: a randomized controlled trial. Br J Anaesth. 106(6):840-850.
Scrascia G, Rotunno C, Guida P, et al. 2014. Perioperative steroids administration in pediatric cardiac surgery: a meta-analysis of randomized controlled trials*. Pediatr Crit Care Med. 15(5):435-442.
Siepe M, Pfeiffer T, Gieringer A, et al. 2011. Increased systemic perfusion pressure during cardiopulmonary bypass is associated with less early postoperative cognitive dysfunction and delirium. Eur J Cardiothorac Surg. 40(1):200-207.
Steinmetz J, Christensen KB, Lund T, Lohse N, Rasmussen LS. 2009. ISPOCD Group. Long-term consequences of postoperative cognitive dysfunction. Anesthesiology. 110(3):548-555.
Svenarud P, Persson M, van der Linden J. 2004. Effect of CO2 insufflation on the number and behavior of air microemboli in open-heart surgery: a randomized clinical trial. Circulation. 109(9):1127-1132.
Tian Z, Dong C, Fujita A, Fujita Y, Hashimoto K. 2018. Expression of heat shock protein HSP-70 in the retrosplenial cortex of rat brain after administration of (R,S)-ketamine and (S)-ketamine, but not (R)-ketamine. Pharmacol Biochem Behav. 172:17-21.
Van Dijk D, Jansen EW, Hijman R, et al. 2002. Cognitive outcome after off-pump and on-pump coronary artery bypass graft surgery: a randomized trial. JAMA. 287(11):1405-1412.
Van Harten AE, Scheeren TW, Absalom AR. 2012. A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia. Anaesthesia. 67(3):280-293.
Wang W, Wang Y, Wu H, et al. 2014. Postoperative cognitive dysfunction: current developments in mechanism and prevention. Med Sci Monit. 20:1908-1912. Published Oct 12.
Wehrle FM, Held U, O'Gorman RT, et al. 2018. Long-term neuroprotective effect of erythropoietin on executive functions in very preterm children (EpoKids): protocol of a prospective follow-up study. BMJ Open. 8(4):e022157. Published Apr 24.
Wesselink EM, Kappen TH, van Klei WA, Dieleman JM, van Dijk D, Slooter AJ. 2015. Intraoperative hypotension and delirium after on-pump cardiac surgery. Br J Anaesth. 115(3):427-433.
Zhou C, Zhu Y, Liu Z, Ruan L. 2016. Effect of dexmedetomidine on postoperative cognitive dysfunction in elderly patients after general anaesthesia: A meta-analysis. J Int Med Res. 44(6):1182-1190.