Delirium Prevention in Postcardiac Surgical Critical Care

Rohan Sanjanwala; Christian Stoppe; Ali Khoynezhad; Aileen Hill; Daniel T Engelman; Rakesh C Arora

doi:10.1016/j.ccc.2020.06.001

Delirium Prevention in Postcardiac Surgical Critical Care

Crit Care Clin. 2020 Oct;36(4):675-690. doi: 10.1016/j.ccc.2020.06.001.

Authors

Rohan Sanjanwala¹, Christian Stoppe², Ali Khoynezhad³, Aileen Hill⁴, Daniel T Engelman⁵, Rakesh C Arora⁶

Affiliations

¹ Cardiac Sciences Program, St. Boniface Hospital, CR3015-369 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada.
² Department of Intensive Care Medicine, 3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen D-52074, Germany; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Würzburg, Würzburg, Germany.
³ Department of Cardiothoracic Surgery, MemorialCare Long Beach Medical Center, 2801 Atlantic Avenue, Long Beach, CA 90806, USA.
⁴ Department of Intensive Care Medicine, 3CARE-Cardiovascular Critical Care & Anesthesia Evaluation and Research, University Hospital RWTH Aachen, Pauwelsstraße 30, Aachen D-52074, Germany.
⁵ Heart and Vascular Program, Baystate Health and University of Massachusetts Medical School-Baystate, 759 Chestnut Street, Springfield, MA 01199, USA.
⁶ Cardiac Sciences Program, St. Boniface Hospital, CR3015-369 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada; Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: rakeshcarora@gmail.com.

PMID: 32892821
DOI: 10.1016/j.ccc.2020.06.001

Abstract

This review provides an overview for health care teams involved in the perioperative care of cardiac surgery patients. The intention is to summarize key determinants of delirium, its impact on short- and long-term outcomes as well as to discuss effective management strategies. The first component of this review examines the prevalence and the factors associated with an increased risk of postoperative delirium. A multitude of predisposing (eg, baseline vulnerability and comorbidities) and precipitating (eg, type of cardiac surgery and postoperative care) factors that contribute to the occurrence of delirium are discussed.

Keywords: Cardiac surgery; Delirium; Enhanced recovery; Intensive care unit; Perioperative care.

Publication types

Review

MeSH terms

Cardiac Surgical Procedures*
Critical Care
Delirium*
Humans
Intensive Care Units
Postoperative Care
Postoperative Complications
Risk Factors