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Metabolic disturbance affects postoperative cognitive function in patients undergoing cardiopulmonary bypass

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Abstract

Objectives

Postoperative delirium is a common neuropsychiatric syndrome after coronary artery bypass grafting (CABG). We aimed to assess and compare clinical outcomes of CABG patients with delirium with a specific focus on the blood biochemical parameters.

Methods

This investigation was carried out on the 90 eligible patients undergoing CABG. Delirium was measured using the Neecham confusion scale and assessed patients were divided into two groups of delirium (n = 43) and non-delirium (n = 47). Preoperative variables and intraoperative and postoperative outcomes were compared.

Results

Delirium patients were older (p = 0.003) and had longer intubation time (p = 0.003). Non-delirium patients obtained a significantly higher Neecham confusion score (p = 0.001), and delirium patients experienced a hyperglycemic state at intraoperative (p = 0.004), intubation (p = 0.03), and extubation time (p = 0.02). Lower value of pH was seen at intubation (p = 0.03) and extubation periods (p = 0.001) in delirium group. A significant difference in base excess was observed between two groups at intubation (p = 0.04) and extubation periods (p = 0.004). Potassium level showed a significant decrease in delirium group at intubation (p = 0.01) and extubation periods (p = 0.001). Multivariate regression indicated that aging (OR = 1.08, p = 0.01), narcotic consumption (OR = 3.27, p = 0.05), DM (OR = 3.03, p=0.03), and prolonged intubation (OR = 1.18, p = 0.03) are predictors of delirium. Postoperative hyperglycemia (OR = 1.01, p = 0.002), low pH value (OR = 2.62, p = 0.02), and low potassium level (OR = 3.25, p = 0.03) are associated with development of delirium.

Conclusions

Postoperative metabolic disturbance and electrolyte imbalances are closely related to the development of delirium after CABG and need to be considered more carefully. Aging, DM, and preoperative use of narcotics are strong predictors of delirium following CABG.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Cardiac Intensive Care Unit, Shahid Chamran Heart Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Fahimeh Shirvani

  2. Neuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran

    Mohsen Sedighi

  3. Department of Cardiovascular Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Mehran Shahzamani

Authors
  1. Fahimeh Shirvani
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  2. Mohsen Sedighi
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  3. Mehran Shahzamani
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Corresponding author

Correspondence to Mohsen Sedighi.

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Ethical approval

This study has been approved by the local Ethics Committee (IR.IAU.KHUISF.REC.1397.152), and written informed consent was obtained from all individuals.

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The authors declare that they have no conflict of interest.

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Written informed consent was obtained from all patients who participated in the study.

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Shirvani, F., Sedighi, M. & Shahzamani, M. Metabolic disturbance affects postoperative cognitive function in patients undergoing cardiopulmonary bypass. Neurol Sci 43, 667–672 (2022). https://doi.org/10.1007/s10072-021-05308-w

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  • DOI: https://doi.org/10.1007/s10072-021-05308-w

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