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Mind injuries after cardiac surgery.

Daniele Rovai1, Daniela Giannessi, Maria G Andreassi

  • 1aCNR, Institute of Clinical Physiology bBiomedicine, CNR, Institute of Clinical Physiology cClinical Psychology, Department of Surgery, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa dCardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, Massa, Italy.

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Summary
This summary is machine-generated.

Cardiac surgery patients often experience cognitive and psychological issues like delirium and depression, impacting recovery. This review explores the causes and potential treatments for these

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cardiology

Background:

  • Post-cardiac surgery patients frequently develop delirium, cognitive dysfunction, depression, and anxiety.
  • These neuropsychiatric complications significantly worsen patient prognosis and quality of life.

Purpose of the Study:

  • To review the clinical presentations of postoperative cognitive and psychological problems ('mind injuries') after cardiac surgery.
  • To explore their pathophysiological mechanisms.
  • To discuss potential prevention and treatment strategies.

Main Methods:

  • This is a narrative review.
  • It synthesizes information on the clinical features, mechanisms, and management of postoperative cognitive and psychological issues.

Main Results:

  • Postoperative cognitive dysfunction (POCD) involves multiple mechanisms and risk factors, potentially leading to cerebral microvascular damage.
  • Postoperative depression is linked to genetic/psychosocial factors, neuroendocrine activation, and neuroinflammation.
  • These neuroinflammatory and biochemical changes may trigger depression by affecting brain areas.

Conclusions:

  • Cognitive and psychological problems are significant, multifactorial complications after cardiac surgery.
  • Understanding the underlying mechanisms is crucial for developing effective prevention and treatment strategies.
  • Addressing these 'mind injuries' is essential for improving patient outcomes.