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A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia.
MedLine Citation:
PMID:  22321085     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Postoperative cognitive dysfunction is receiving increasing attention, particularly as it mainly affects the (growing) elderly population. Until recently, cognitive deficits after cardiac surgery were thought to be caused by physiological disturbances associated with the cardiopulmonary bypass technique. Although the technique of 'off-pump' coronary revascularisation may potentially be associated with improved outcome, long-term follow-up studies have failed to demonstrate a significant reduction in the incidence of postoperative cognitive dysfunction. The focus of research is thus shifting from cardiopulmonary bypass to other factors common to both techniques, such as surgery, anaesthesia and patient-related predisposing factors. Priming of the immune system by ageing and atherosclerosis may result in an exaggerated systemic and cerebral inflammatory response to cardiac surgery and anaesthesia, causing neuronal loss or dysfunction resulting in cognitive dysfunction. We briefly discuss the evidence for cardiopulmonary bypass-related neuronal injuries in adult cardiac surgery patients, and review the evidence that immune priming is a key factor in the pathogenesis of cognitive dysfunction after cardiac surgery.
Authors:
A E van Harten; T W L Scheeren; A R Absalom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia     Volume:  67     ISSN:  1365-2044     ISO Abbreviation:  Anaesthesia     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  280-93     Citation Subset:  AIM; IM    
Copyright Information:
Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.
Affiliation:
Research Fellow  Professor, Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, The Netherlands.
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