Update in Postoperative Cognitive Dysfunction after Cardiac Surgery: A Literature Review
Cognitive Dysfunction after Cardiac Surgery
DOI:
https://doi.org/10.31584/psumj.2022254213Keywords:
cardiac surgery, cognitive function, elderlyAbstract
Cardiac surgery is a common surgery in the elderly including of coronary artery bypass surgery and valvular heart surgery. The major complication after cardiac surgery is neurological complication. Postoperative cognitive dysfunction (POCD) is one of the major neurological complications. Patients who have neurological complications are reported to have a lower ability to form and organize their thoughts and understanding after the completion of surgery. POCD has the consequences in all health aspects. For instance, a longer period of hospital stay, poor quality of life and the increased rate of other complications.
However, there is no precise definition of cognitive impairment. In order to diagnose, preoperative neuropsychological tests are normally compared with postoperative neuropsychological tests. However, other similar neurological diseases after the surgery should be ruled out.
The risk factors for POCD were categorized into 3 major factors. Firstly, surgical factors which are systematic inflammation, cerebral microemboli, global hypoperfusion, induced hypothermia, and extreme hemodilution. Secondly, anesthetic factor which is total intravenous anesthesia. Thirdly, patient factors which are age, underlying disease, genetic, and smoking habit. If these mentioned conditions can be addressed before surgery, the incidence of cognitive impairment is very likely to be lower.
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