Posthypoxic encephalopathy in patients after cardiac surgery: etiological, pathogenetic, and clinical aspects (a literature review)
| Autor: | T. M. Alekseeva, O. A. Portik, M. P. Topuzova |
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| Jazyk: | ruština |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Неврология, нейропсихиатрия, психосоматика, Vol 10, Iss 3, Pp 121-128 (2018) |
| Druh dokumentu: | article |
| ISSN: | 2074-2711 2310-1342 |
| DOI: | 10.14412/2074-2711-2018-3-121-128 |
| Popis: | Post-hypoxic encephalopathy is a brain damage manifested by neurological, neuropsychiatric, and mental disorders, which is caused by a reduction in cerebral blood flow and by a resultant effect of an episode of hypoxia of various etiology and duration. This complication is most characteristic of patients who have undergone cardiac surgery in view of the high prevalence and severity of clinical manifestations, worse quality of life, the longer length of hospital stay, and the higher cost of treatment and rehabilitation. To determine the individual management tactics for such patients, combining both successful surgical treatment, by reducing perioperative stress, and prevention of cerebral complications, it is necessary to analyze the patterns of their development. The role of pathophysiological risk factors, including preoperative, perioperative and postoperative ones, for posthypoxic encephalopathy, is considered. Its preoperative risk factors include age, gender, concomitant diseases, education level, and cognitive functions before surgery, cardiac morphofunctional changes, and depressive disorders. There are surgery-related (type and duration of anesthesia, operating-suite temperatures, and hyperglycemia) and postoperative (pain syndrome after surgical intervention, sleep disorders, and the environment) risk factors. Emphasis is placed on the technical characteristics of on-pump operations, among which there are cerebral hypoperfusion, microembolism, non-pulsatile flow, and duration of extracorporeal circulation. Classifications of cerebral complications are presented. Different types of brain dysfunction are analyzed to assess their incidence rates, clinical features, and dynamics in the postoperative period. |
| Databáze: | Directory of Open Access Journals |
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