Top

Published in:

01-02-2011 | Commentary

Is cortisol the key to the pathogenesis of delirium after coronary artery bypass graft surgery?

Authors: Jakub Kazmierski, Iwona Kloszewska

Published in: Critical Care | Issue 1/2011

Abstract

Postoperative delirium is a serious complication of cardiac surgery. However, the pathophysiology of this mental syndrome is largely unknown. Recent findings suggest an association between elevated level of cortisol and postoperative delirium. Further studies should investigate the mechanisms responsible for excessive perioperative cortisol secretion.

Mu D-L, Wang D-X, Li L-H, Shan G-J, Li J, Yu Q-J, Shi C-X: High serum cortisol level is associated with increased risk of delirium after coronary artery bypass graft surgery: a prospective cohort study. Crit Care. 2010, 14: R238-PubMedPubMedCentralCrossRef

McIntosh TK, Bush HL, Yeston NS, Grasberger R, Palter M, Aun F, Egdahl RH: Beta-endorphin, cortisol and postoperative delirium: a preliminary report. Psychoneuroendocrinology. 1985, 10: 303-313. 10.1016/0306-4530(85)90007-1.PubMedCrossRef

Detroyer E, Dobbels F, Verfaillie E, Meyfroidt G, Sergeant P, Milisen K: Is preoperative anxiety and depression associated with onset of delirium after cardiac surgery in older patients? A prospective cohort study. J Am Geriatr Soc. 2008, 56: 2278-2284. 10.1111/j.1532-5415.2008.02013.x.PubMedCrossRef

Bucerius J, Gummert JF, Borger MA, Walther T, Doll N, Falk V, Schmitt DV, Mohr FW: Predictors of delirium after cardiac surgery delirium: effect of beating-heart (off-pump) surgery. J Thorac Cardiovasc Surg. 2004, 127: 57-64. 10.1016/S0022-5223(03)01281-9.PubMedCrossRef

Martin BJ, Buth KJ, Arora RC, Baskett RJ: Delirium as a predictor of sepsis in post-coronary artery bypass grafting patients: a retrospective cohort study. Crit Care. 2010, 14: R171-10.1186/cc9273.PubMedPubMedCentralCrossRef

Kazmierski J, Kowman M, Banach M, Fendler W, Okonski P, Banys A, Jaszewski R, Rysz J, Mikhailidis DP, Sobow T, Kloszewska I, IPDACS Study: Incidence and predictors of delirium after cardiac surgery: results from The IPDACS Study. J Psychosom Res. 2010, 69: 179-185. 10.1016/j.jpsychores.2010.02.009.PubMedCrossRef

Rudolph JL, Jones RN, Levkoff SE, Rockett C, Inouye SK, Sellke FW, Khuri SF, Lipsitz LA, Ramlawi B, Levitsky S, Marcantonio ER: Derivation and validation of a preoperative prediction rule for delirium after cardiac surgery. Circulation. 2009, 119: 229-236. 10.1161/CIRCULATIONAHA.108.795260.PubMedPubMedCentralCrossRef

Lupien SJ, Gillin CJ, Hauger RL: Working memory is more sensitive than declarative memory to the acute effects of corticosteroids: a dose-response study in humans. Behav Neurosci. 1999, 113: 420-430. 10.1037/0735-7044.113.3.420.PubMedCrossRef

Chida K, Ogasawara K, Aso K, Suga Y, Kobayashi M, Yoshida K, Terasaki K, Tsushina E, Ogawa A: Postcarotid endarterectomy improvement in cognition is associated with resolution of crossed cerebellar hypoperfusion and increase in 123I-iomazenil uptake in the cerebral cortex: a SPECT study. Cerebrovasc Dis. 2010, 29: 343-351. 10.1159/000278930.PubMedCrossRef

10.

Marrocco-Trischitta MM, Tiezzi A, Svampa MG, Bandiera G, Camilli S, Stillo F, Petasecca P, Sampogna F, Abeni D, Guerrini P: Perioperative stress response to carotid endarterectomy: the impact of anesthetic modality. J Vasc Surg. 2004, 39: 1295-1304. 10.1016/j.jvs.2004.02.002.PubMedCrossRef

11.

Raison CL, Miller AH: When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders. Am J Psychiatry. 2003, 160: 1554-1565. 10.1176/appi.ajp.160.9.1554.PubMedCrossRef

12.

Plaschke K, Fichtenkamm P, Schramm C, Hauth S, Martin E, Verch M, Karck M, Kopitz J: Early postoperative delirium after open-heart cardiac surgery is associated with decreased bispectral EEG and increased cortisol and interleukin-6. Intensive Care Med. 2010, 36: 2081-2089. 10.1007/s00134-010-2004-4.PubMedCrossRef

13.

van Munster BC, Korevaar JC, Zwinderman AH, Leeflang MM, de Rooij SE: The association between delirium and the apolipoprotein E epsilon 4 allele: new study results and a meta-analysis. Am J Geriatr Psychiatry. 2009, 17: 856-862. 10.1097/JGP.0b013e3181ab8c84.PubMedCrossRef

14.

van Munster BC, de Rooij SE, Yazdanpanah M, Tienari PJ, Pitkälä KH, Osse RJ, Adamis D, Smit O, van der Steen MS, van Houten M, Rahkonen T, Sulkava R, Laurila JV, Strandberg TE, Tulen JH, Zwang L, MacDonald AJ, Treloar A, Sijbrands EJ, Zwinderman AH, Korevaar JC: The association of the dopamine transporter gene and the dopamine receptor 2 gene with delirium, a meta-analysis. Am J Med Genet B Neuropsychiatr Genet. 2010, 153B: 648-655.PubMed

15.

Shi CM, Wang DX, Chen KS, Gu XE: Incidence and risk factors of delirium in critically ill patients after non-cardiac surgery. Chin Med J (Engl). 2010, 123: 993-999.

Title: Is cortisol the key to the pathogenesis of delirium after coronary artery bypass graft surgery?
Authors: Jakub Kazmierski
Iwona Kloszewska
Publication date: 01-02-2011
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2011
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc9372

2024 ASCO Annual Meeting

Springer Medicine

Is cortisol the key to the pathogenesis of delirium after coronary artery bypass graft surgery?

Abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2011

Revisiting the value of pre-hospital tracheal intubation: an all time systematic literature review extracting the Utstein airway core variables

Fitting a square peg into a round hole: are the current Surviving Sepsis Campaign guidelines feasible for Africa?

Effect of erythropoietin on level of circulating endothelial progenitor cells and outcome in patients after acute ischemic stroke

Clinical review: Blood purification for sepsis

Circulating soluble urokinase plasminogen activator receptor is stably elevated during the first week of treatment in the intensive care unit and predicts mortality in critically ill patients

Blood transfusion during cardiac surgery is associated with inflammation and coagulation in the lung: a case control study