» Articles » PMID: 39346790

Research Progress of Postoperative Cognitive Dysfunction in Cardiac Surgery Under Cardiopulmonary Bypass

Overview
Journal Ibrain
Specialty Neurology
Date 2024 Sep 30
PMID 39346790
Authors
Affiliations
Soon will be listed here.
Abstract

Cardiopulmonary bypass (CPB) is often used in cardiothoracic surgery because its nonphysiological state causes pathophysiological changes in the body, causing multiorgan and multitissue damage to varying degrees. Postoperative cognitive dysfunction (POCD) is a common central nervous system complication after cardiac surgery. The etiology and mechanism of POCD are not clear. Neuroinflammation, brain mitochondrial dysfunction, cerebral embolism, ischemia, hypoxia, and other factors are related to the pathogenesis of POCD. There is a close relationship between CPB and POCD, as CPB can cause inflammation, hypoxia and reperfusion injury, and microemboli formation, all of which can trigger POCD. POCD increases medical costs, seriously affects patients' quality of life, and increases mortality. Currently, there is a lack of effective treatment methods for POCD. Commonly used methods include preoperative health management, reducing inflammation response during surgery, preventing microemboli formation, and implementing individualized rehabilitation programs after surgery. Strengthening preventive measures can minimize the occurrence of POCD and its adverse effects.

Citing Articles

Sevoflurane versus propofol on immediate postoperative cognitive dysfunction in patients undergoing cardiac surgery under cardiopulmonary bypass: a comparative analysis.

Zhao N, Qin R, Liu B, Zhang D J Cardiothorac Surg. 2025; 20(1):54.

PMID: 39794827 PMC: 11724596. DOI: 10.1186/s13019-024-03327-0.

References
1.
Bowden T, Hurt C, Sanders J, Aitken L . Predictors of cognitive dysfunction after cardiac surgery: a systematic review. Eur J Cardiovasc Nurs. 2021; 21(3):192-204. DOI: 10.1093/eurjcn/zvab086. View

2.
Shi J, Zou X, Jiang K, Wang F . SIRT1 mediates improvement of cardiac surgery-induced postoperative cognitive dysfunction via the TLR4/NF-κB pathway. World J Biol Psychiatry. 2019; 21(10):757-765. DOI: 10.1080/15622975.2019.1656820. View

3.
Gao Z, Li Z, Deng R, Liu Q, Xiao Q, Han J . Dexmedetomidine improves postoperative neurocognitive disorder after cardiopulmonary bypass in rats. Neurol Res. 2020; 43(2):164-172. DOI: 10.1080/01616412.2020.1833154. View

4.
Moller J, Cluitmans P, Rasmussen L, Houx P, Rasmussen H, Canet J . Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction. Lancet. 1998; 351(9106):857-61. DOI: 10.1016/s0140-6736(97)07382-0. View

5.
Bhushan S, Li Y, Huang X, Cheng H, Gao K, Xiao Z . Progress of research in postoperative cognitive dysfunction in cardiac surgery patients: A review article. Int J Surg. 2021; 95:106163. DOI: 10.1016/j.ijsu.2021.106163. View