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Updated: Dec 5, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Association between postoperative changes in the gut microbiota and pseudopsia after cardiac surgery: prospective
Masaki Maekawa1, Kenji Yoshitani2, Musashi Yahagi1
1Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan.
Background:
Delirium after cardiac surgery affects mortality, but the mechanism remains unclear. Previous studies have reported gut microbiota are associated with brain activity. Systemic inflammation and antibiotics can damage the gut microbiota after cardiac surgery. We aimed to investigate changes in the gut microbiota and the association between the gut microbiota and delirium after cardiac surgery.
Methods:
Twenty-one patients who underwent cardiac surgery were enrolled. Microbiota counts and fecal organic acid concentrations were measured in fecal samples harvested before surgery, just after surgery, and before discharge. To quantify the microbiota, we extracted total RNA fractions and examined gut microbiota composition using 16S and 23S rRNA-targeted quantitative-reverse Transcription-PCR. Postoperative delirium, insomnia, and pseudopsia were assessed for 1 week. Postoperative total bacterial counts changed significantly from 10.2 ± 0.2 log10 cells/g of feces to 9.8 ± 0.5 in the first postoperative samples (p = 0.003) and 10.0 ± 0.4 in the samples before discharge (p = 0.039). Fecal pH was 6.9 ± 0.6 before surgery and 7.4 ± 0.7 in the first postoperative samples (p = 0.001). Postoperative Staphylococcus and Pseudomonas counts were significantly higher in patients with postoperative pseudopsia than in patients without pseudopsia (3.2 ± 1.3 vs. 5.4 ± 0.9; p = 0.012 and 1.7 ± 0.8 vs. 4.6 ± 2.7; p = 0.001).
Conclusions:
Total bacterial counts were significantly lower after surgery and until discharge. Fecal pH was significantly higher than preoperative levels. Staphylococcus and Pseudomonas counts were significantly higher in patients with postoperative pseudopsia.
Insights
Cardiac surgery alters gut microbiota, with lower total bacterial counts and higher fecal pH post-operation. Specific bacteria like Staphylococcus and Pseudomonas were elevated in patients experiencing pseudopsia.
Area of Science:
- Microbiology
- Gastroenterology
- Neurosurgery
Background:
- Delirium following cardiac surgery is a significant concern impacting mortality, yet its underlying mechanisms remain incompletely understood.
- Emerging evidence suggests a link between gut microbiota composition and brain activity.
- Cardiac surgery, systemic inflammation, and antibiotic use can disrupt the gut microbiota.
Purpose of the Study:
- To investigate alterations in gut microbiota composition after cardiac surgery.
- To explore the association between gut microbiota changes and the occurrence of postoperative delirium.
Main Methods:
- Quantitative reverse transcription-PCR was used to analyze 16S and 23S rRNA in fecal samples from 21 cardiac surgery patients.
- Fecal samples were collected pre-surgery, immediately post-surgery, and before discharge.
- Postoperative delirium, insomnia, and pseudopsia were monitored for one week.
Main Results:
- Total bacterial counts significantly decreased post-surgery and remained lower at discharge (p<0.05).
- Fecal pH increased significantly in the early postoperative period compared to pre-surgery levels (p<0.01).
- Elevated postoperative counts of Staphylococcus and Pseudomonas were observed in patients with pseudopsia (p<0.05).
Conclusions:
- Cardiac surgery leads to significant changes in gut microbiota, characterized by reduced total bacterial load and increased fecal pH.
- Specific bacterial genera, Staphylococcus and Pseudomonas, were found in higher abundance in patients who developed pseudopsia.
- These findings suggest a potential role for gut dysbiosis in the pathophysiology of postoperative delirium and related symptoms.
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