Review article
POSTOPERATIVE MENTAL DISORDERS IN CARDIOVASCULAR SURGERY
DINKO TONKOVIĆ TONKOVIĆ
; School of Medicine, University of Zagreb, Chair of Anesthesiology and Resuscitation, Zagreb, Croatia
DRAGAN KOROLIJA MARINIĆ
; University Department of Surgery, Zagreb, Croatia
ROBERT BARONICA
; University Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb University Hospital Center, Zagreb, Croatia
DAGMAR OBERHOFER
; University Department of Anesthesiology, Resuscitation and Intensive Care, Sveti Duh University Hospital, Zagreb, Croatia
DANIJELA BANDIĆ PAVLOVIĆ
; School of Medicine, University of Zagreb, Chair of Anesthesiology and Resuscitation, Zagreb, Croatia
MLADEN PERIĆ
; School of Medicine, University of Zagreb, Chair of Anesthesiology and Resuscitation, Zagreb, Croatia
Abstract
Postoperative mental disorders are a common complication of cardiovascular surgery, with serious consequences. The main types of postoperative mental disorders include postoperative delirium and postoperative cognitive dysfunction. Their incidence ranges up to 15%-80%. Postoperative mental disorders may be reversible and irreversible. Although reversible in most cases, postoperative mental disorders are associated with increased mortality, morbidity and increasing costs of treatment. The treatment is usually symptomatic and may be associated with dangerous side effects. Safer and more effective is preventive action. Preoperative preventive action need to recognize, avoid and optimize risk factors. Intraoperative prevention involves maintaining optimal oxygenation of the brain during cardiovascular surgery. For postoperative prevention, multimodal approach is applied. It includes early extubation, early enteral nutrition, early mobilization, regular evaluation of cognitive function, activation of cognitive function and optimal analgesia, which requires teamwork of medical staff who care for patients. Combining all these methods can show promising results in reducing the incidence of postoperative mental disorders as a complication in cardiovascular surgery.
Keywords
postoperative mental disorders; delirium; cognitive dysfunction; cardiovascular surgery
Hrčak ID:
93246
URI
Publication date:
30.10.2012.
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