在接受心脏手术的老年患者中,术后妄想和认知功能障碍:两种血液氧化器之间的随机比较
Lorenzo Mantovani1, Elisa Mikus1, Elena Tenti1
1Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy.
Bioengineering (Basel, Switzerland)
|December 23, 2023
概括
一个新的氧化器系统,RemoweLL 2,在减少老年心脏手术患者手术后妄想和认知衰退方面显示出有前途. 与传统系统相比,这种创新的心肺旁路器件还显示了较低的炎症标志物.
科学领域:
- 心血管外科心血管外科
- 神经科学是一个神经科学.
- 生物材料科学 生物材料科学
背景情况:
- 心脏手术期间的体外循环会影响老年患者,增加妄想症,认知障碍和死亡率的风险.
- 传统的氧化器系统可能会导致不良的神经和炎症结果.
研究的目的:
- 评估新型氧化器系统 (RemoweLL 2) 与传统系统 (Inspire) 在减少术后妄想和认知功能障碍方面的有效性.
- 在接受心肺旁路术 (CPB) 的老年患者中评估血清炎症标志物.
主要方法:
- 154名接受CPB的老年患者 (>65岁) 被随机分配给RemoweLL 2 (n=81) 或Inspire (n=73).
- 使用神经精神病学和MoCa测试在医院内和CPB后6个月评估了妄和认知衰退的发生率.
- 测量了血清炎症生物标志物 (乙醇酶,白细胞,中性粒细胞).
主要成果:
- 与RemoweLL 2 (16.0%) 相比,与Inspire (26.0%,p=0.093) 相比,观察到一个较低的严重术后妄想发病率的趋势.
- 在RemoweLL 2组中发现了明显较低的乙醇酶 (p=0.049),白细胞 (p=0.006) 和中性粒细胞 (p=0.003) 的水平.
- 两组之间基线变量没有显著差异.
结论:
- 像RemoweLL 2这样的新型氧化器技术可能会改善接受CPB的老年患者的神经认知和神经学结果.
- 在心脏手术后,RemoweLL 2系统显示了减少炎症和妄想的潜力.
- 需要进一步的研究来证实这些发现并优化CPB设备设计.
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