Hemodynamic Control and Delirium

Abstract

One of the adverse outcomes common in older surgical patients is postoperative delirium. The incidence of postoperative delirium varies depending on the type of patients studied, the tools used to measure delirium and the frequency of measurement. Although studies have identified predisposing and precipitating risk factors, to date, no single precipitating factor that can be modified by intraoperative anesthesia management has been found. Several studies identified intraoperative hypotension to be an important precipitating factor. However, this finding was not universally supported. Recent work on intraoperative blood pressure fluctuation and postoperative delirium may contribute to bridge this apparent discrepancy. These data indicate significantly larger intraoperative fluctuation in blood pressure in patients with postoperative delirium. Further research is needed to determine what type of patients are at risk for blood pressure lability and the effects of supporting blood pressure on the incidence of postoperative delirium.

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Correspondence to Jan Hirsch.

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This article is part of the Topical collection on Perioperative Delirium.

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Hirsch, J. Hemodynamic Control and Delirium. Curr Anesthesiol Rep 5, 17–23 (2015). https://doi.org/10.1007/s40140-014-0096-z

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Keywords

  • Surgery
  • Blood pressure
  • Delirium
  • Hypotension
  • Hemodynamics
  • Perioperative complications