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Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review

1
Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40752 Katowice, Poland
2
Students’ Scientific Society, Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40752 Katowice, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(10), 3183; https://doi.org/10.3390/jcm9103183
Received: 1 September 2020 / Revised: 29 September 2020 / Accepted: 29 September 2020 / Published: 30 September 2020
(This article belongs to the Special Issue Clinical Management of Perioperative Brain Health)
Postoperative delirium (POD) and postoperative cognitive decline (deficit) (POCD) are related to a higher risk of postoperative complications and long-term disability. Pathophysiology of POD and POCD is complex, elusive and multifactorial. Intraoperative hypotension (IOH) constitutes a frequent and vital health hazard in the perioperative period. Unfortunately, there are no international recommendations in terms of diagnostics and treatment of neurocognitive complications which may arise from hypotension-related hypoperfusion. Therefore, we performed a comprehensive review of the literature evaluating the association between IOH and POD/POCD in the non-cardiac setting. We have concluded that available data are quite inconsistent and there is a paucity of high-quality evidence convincing that IOH is a risk factor for POD/POCD development. Considerable heterogeneity between studies is the major limitation to set up reliable recommendations regarding intraoperative blood pressure management to protect the brain against hypotension-related hypoperfusion. Further well-designed and effectively-performed research is needed to elucidate true impact of intraoperative blood pressure variations on postoperative cognitive functioning. View Full-Text
Keywords: hypotension; cognitive functioning; cognitive decline; delirium; neurocognitive complications; perioperative hypotension; cognitive functioning; cognitive decline; delirium; neurocognitive complications; perioperative
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MDPI and ACS Style

Krzych, Ł.J.; Pluta, M.P.; Putowski, Z.; Czok, M. Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review. J. Clin. Med. 2020, 9, 3183. https://doi.org/10.3390/jcm9103183

AMA Style

Krzych ŁJ, Pluta MP, Putowski Z, Czok M. Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review. Journal of Clinical Medicine. 2020; 9(10):3183. https://doi.org/10.3390/jcm9103183

Chicago/Turabian Style

Krzych, Łukasz J.; Pluta, Michał P.; Putowski, Zbigniew; Czok, Marcelina. 2020. "Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review" J. Clin. Med. 9, no. 10: 3183. https://doi.org/10.3390/jcm9103183

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