Delirio postoperatorio / Postoperative delirium

Noviembre 22, 2017. No. 2910

Salino hipertónico en la prevención del delirio en ancianos operados de la cadera Hypertonic saline for prevention of delirium in geriatric patients who underwent hip surgery. Xin X1, Xin F2, Chen X1, Zhang Q1, Li Y1, Huo S1, Chang C1, Wang Q3. Author information J Neuroinflammation. 2017 Nov 14;14(1):221. doi: 10.1186/s12974-017-0999-y. Abstract BACKGROUND: Postoperative delirium (POD) is a common disorder in the elderly patients, and neuroinflammation is the possible underlying mechanism. This study is designed to determine whether or not hypertonic saline (HS) pre-injection can alleviate POD in aged patients. CONCLUSION: HS can alleviate POD in geriatric patients and may inhibit the secretion of inflammatory factors by monocytes. KEYWORDS: Cytokines; Elderly; Hypertonic saline; Monocytes; Neuroinflammation; Postoperative delirium PDF Nivel preoperatorio alto de IL-6 es un factor de riesgo de inicio de delirio postoperatorio en viejos Pre-Operative, High-IL-6 Blood Level is a Risk Factor of Post-Operative Delirium Onset in Old Patients. Capri M1, Yani SL2, Chattat R3, Fortuna D4, Bucci L5, Lanzarini C5, Morsiani C6, Catena F7, Ansaloni L8, Adversi M9, Melotti MR10, Di Nino G10, Franceschi C1. Front Endocrinol (Lausanne). 2014 Oct 17;5:173. doi: 10.3389/fendo.2014.00173. eCollection 2014. Author information Abstract BACKGROUND: Post-operative delirium (POD) is a common complication in elderly patients undergoing surgery, but the underpinning causes are not clear. We hypothesized that inflammaging, the subclinical low and chronic grade inflammation characteristic of old people, can contribute to POD onset. Accordingly, we investigated the association of pre-operative and circulating cytokines in elderly patients, admitted for elective and emergency surgery. CONCLUSION: Pre-operative, high-plasma level of IL-6 was significantly associated with POD onset. We propose IL-6 as an additional risk factor of POD onset together with the previously identified factors. Discovery of all risk factors contributing to POD onset will permit to improve hospitalized patient management and the decrease of healthcare cost. KEYWORDS: IL-6; aging; inflammaging; inflammatory cytokines; post-operative delirium PDF DELIRIUM POST OPERATORIO EN PACIENTES ANCIANOS: UNA REVISIÓN DEL TEMA Nicolás García S. y Ricardo Fuentes H Rev Chil Anest, 2013; 42: 162-166 INTRODUCCIÓN Y CONTEXTO Los cambios demográficos a nivel nacional, dados principalmente por la disminución de la fecundidad y el aumento de la esperanza de vida, han producido un aumento dramático de la población quirúrgica mayor de 65 años. Datos del Instituto Nacional de Estadística (INE) muestran que entre 1907 y 1952 el ritmo de crecimiento medio anual de la población del país entre los distintos grupos de edad era prácticamente el mismo, situación que cambió entre 1952 y el 2002, en que el ritmo de crecimiento de los adultos mayores casi triplicó al de los menores de 15 años. Así, entre los años 2001 y 2011 en el Hospital Clínico de la Pontificia Universidad Católica de Chile se realizaron un total de 110.820 cirugías, de las cuales 28.055 fueron pacientes mayores de 65 años, correspondiente al 25,3% del total, con un promedio de edad de 77 años. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information International Anesthesia Research Society Annuals Meetings USA Informes / Information

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Delirio postoperatorio en geriatría / Postoperative delirium in geriatrics

Marzo 29, 2017. No. 2643

Delirio postoperatorio en geriatría Postoperative Delirium in the Geriatric Patient. Schenning KJ1, Deiner SG2. Anesthesiol Clin. 2015 Sep;33(3):505-16. doi: 10.1016/j.anclin.2015.05.007. Epub 2015 Jul 7. Abstract Postoperative delirium, a common complication in older surgical patients, is independently associated with increased morbidity and mortality. Patients older than 65 years receive greater than one-third of the more than 40 million anesthetics delivered yearly in the United States. This number is expected to increase with the aging of the population. Thus, it is increasingly important that perioperative clinicians who care for geriatric patients have an understanding of the complex syndrome of postoperative delirium. KEYWORDS: Geriatric; Management; Postoperative delirium; Risk factors; Screening PDF Demencia y delirio, resultados en pacientes con fracturas de cadera de edad avanzada. Dementia and delirium, the outcomes in elderly hip fracture patients. Mosk CA1, Mus M1, Vroemen JP1, van der Ploeg T2, Vos DI1, Elmans LH3, van der Laan L1. Clin Interv Aging. 2017 Mar 10;12:421-430. doi: 10.2147/CIA.S115945. eCollection 2017. Abstract BACKGROUND: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium. METHODS: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc., Verona, WI, USA) was used to assess data between January 2014 and September 2015. All patients presented were aged ≥70 years with a hip fracture, who underwent surgery with osteosynthesis or arthroplasty. Patients were excluded in case of a pathological or a periprosthetic hip fracture, multiple traumatic injuries, and high-energy trauma. Patient and surgical characteristics were documented. Postoperative outcomes were noted. Delirium was screened using Delirium Observation Screening Scale and dementia was assessed from medical notes. RESULTS: Of a total of 566 included patients, 75% were females. The median age was 84 years (interquartile range: 9). Delirium was observed in 35%. Significant risk factors for delirium were a high American Society of Anesthesiology score, delirium in medical history, functional dependency, preoperative institutionalization, low hemoglobin level, and high amount of blood transfusion. Delirium was correlated with a longer hospital stay (P=0.001), increased association with complications (P<0.001), institutionalization (P<0.001), and 6-month mortality (P<0.001). Patients with dementia (N=168) had a higher delirium rate (57.7%, P<0.001) but a shorter hospital stay (P<0.001). There was no significant difference in the 6-month mortality between delirious patients with (34.0%) and without dementia (26.3%). CONCLUSION: Elderly patients with a hip fracture are vulnerable for delirium, especially when the patient has dementia. Patients who underwent an episode of delirium were at increased risk for adverse outcomes. KEYWORDS: adverse outcomes; complications; delirium; dementia; elderly; hip fracture PDF Intralipid en el tratamiento del delirio postoperatorio Intralipid Treatment for Post Operative Delirium Eldor J Anesth Crit Care Open Access 2017, 7(5): 00273 Abstract Postoperative delirium (POD) is a common and serious adverse event in the elderly patient and is associated with significant morbidity and mortality. A new treatment for POD by intravenous Intralipid injection in the recovery room is first suggested in the medical literature. Keywords: PDF Curso sobre Anestesia en Trasplantes, Cirugía abdominal, Plástica, Oftalmología y Otorrinolaringología. Committee for European Education in Anaesthesiology (CEEA)  y el Colegio de Anestesiólogos de León A.C. Abril 7-9, 2017, León Guanajuato, México Informes  (477) 716 06 16, kikinhedz@gmail.com Congreso Latinoamericano de Anestesia Regional Asociación Latinoamericana de Anestesia Regional, Capítulo México Ciudad de México, Mayo 24-27, 2017 Informes http://r.enviosgrupolahe.com/2e7l0th0feu87f.html  Vacante para Anestesiología Pediátrica Hospital de Especialidades Pediátrico de León, Guanajuato  México  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

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