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Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium.

Publication ,  Journal Article
Smith, PJ; Blumenthal, JA; Hoffman, BM; Rivelli, SK; Palmer, SM; Davis, RD; Mathew, JP
Published in: Ann Am Thorac Soc
February 2016

RATIONALE: Delirium is common following lung transplant and is associated with poorer clinical outcomes. The extent to which intraoperative hemodynamic alterations may contribute to postoperative delirium among lung transplant recipients has not been examined. OBJECTIVES: To examine the impact of intraoperative hemodynamic changes on neurobehavioral outcomes among lung transplant recipients. METHODS: Intraoperative hemodynamic function during lung transplant was assessed in a consecutive series of patients between March and November 2013. Intraoperative cerebral perfusion pressure was assessed every minute in all patients. Following lung transplant, patients were monitored for the presence and severity of delirium using the Confusion Assessment Method and the Delirium Rating Scale until hospital discharge. MEASUREMENTS AND MAIN RESULTS: Sixty-three patients received lung transplants, of whom 23 (37%) subsequently developed delirium. Lower cerebral perfusion pressure was associated with increased risk of delirium (odds ratio [OR], 2.08 per 10-mm Hg decrease; 95% confidence interval [CI], 1.02-4.24; P = 0.043), longer duration of delirium (OR, 1.7 d longer per 10-mm Hg decrease; 95% CI, 1.1-2.7; P = 0.022), and greater delirium severity (b = -0.81; 95% CI, -1.47 to -0.15; P = 0.017). CONCLUSIONS: Poorer cerebral perfusion pressure during lung transplant is associated with greater risk for delirium following transplant, as well as greater duration and severity of delirium, independent of demographic and medical predictors.

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Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

February 2016

Volume

13

Issue

2

Start / End Page

180 / 187

Location

United States

Related Subject Headings

  • Time Factors
  • Severity of Illness Index
  • Risk Factors
  • Prospective Studies
  • Postoperative Complications
  • Odds Ratio
  • Monitoring, Intraoperative
  • Middle Aged
  • Male
  • Lung Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
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Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Rivelli, S. K., Palmer, S. M., Davis, R. D., & Mathew, J. P. (2016). Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium. Ann Am Thorac Soc, 13(2), 180–187. https://doi.org/10.1513/AnnalsATS.201507-454OC
Smith, Patrick J., James A. Blumenthal, Benson M. Hoffman, Sarah K. Rivelli, Scott M. Palmer, Robert D. Davis, and Joseph P. Mathew. “Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium.Ann Am Thorac Soc 13, no. 2 (February 2016): 180–87. https://doi.org/10.1513/AnnalsATS.201507-454OC.
Smith PJ, Blumenthal JA, Hoffman BM, Rivelli SK, Palmer SM, Davis RD, et al. Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium. Ann Am Thorac Soc. 2016 Feb;13(2):180–7.
Smith, Patrick J., et al. “Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium.Ann Am Thorac Soc, vol. 13, no. 2, Feb. 2016, pp. 180–87. Pubmed, doi:10.1513/AnnalsATS.201507-454OC.
Smith PJ, Blumenthal JA, Hoffman BM, Rivelli SK, Palmer SM, Davis RD, Mathew JP. Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium. Ann Am Thorac Soc. 2016 Feb;13(2):180–187.

Published In

Ann Am Thorac Soc

DOI

EISSN

2325-6621

Publication Date

February 2016

Volume

13

Issue

2

Start / End Page

180 / 187

Location

United States

Related Subject Headings

  • Time Factors
  • Severity of Illness Index
  • Risk Factors
  • Prospective Studies
  • Postoperative Complications
  • Odds Ratio
  • Monitoring, Intraoperative
  • Middle Aged
  • Male
  • Lung Transplantation