Cognitive disorders in perioperative and intensive care


Authors: J. Kletečka 1,2;  K. Soumar 2;  Beneš J. 1–3
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, Lékařská fakulta v Plzni, Univerzita Karlova 1;  Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice v Plzni 2;  Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova 3
Published in: Anest. intenziv. Med., 28, 2017, č. 5, s. 297-304
Category: Intensive Care Medicine - Review Article

Overview

Surgery and critical illness represent significant interventions into the integrity of the organism, which can lead to the development of a cognitive disorder. The most common symptoms include confusion and disorders of perception, attention and memory. Several syndromes are distinguished according to the time of their manifestation. Their pathophysiology has not yet been sufficiently clarified. Emergence delirium is a disorder of rapid onset immediately after general anesthesia, occurring more commonly in children, and it is likely associated with the use of inhalational agents. It is transient, partially preventable, nevertheless connected with a risk of major postoperative complications. The intensive care unit and postoperative delirium is usually associated with a longer hospital stay and increased morbidity and mortality. Screening is essential for its diagnosis, as well as a search and treatment of possible causes. No specific medication influencing significantly the delirium duration and course is currently available. Integration of care bundles including delirium management markedly improves patients’ outcome. Cognitive disorders are a part of long-term consequences of surgery and critical condition. The occurrence and importance of these conditions is still significantly underestimated although their impact on the quality of daily living of patients is fundamental.

Keywords:
cognitive disorders – delirium – postoperative cognitive dysfunction


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Anaesthesiology, Resuscitation and Inten Intensive Care Medicine
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