Special Issue "Clinical Management of Perioperative Brain Health"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Anesthesiology".

Deadline for manuscript submissions: 30 September 2021.

Special Issue Editor

Prof. Dr. Łukasz Krzych
E-Mail Website
Guest Editor
Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
Interests: perioperative medicine; intensive care; biomarkers; complications; neurocognitive decline; delirium; subarrahnoid haemorhhage

Special Issue Information

Dear Colleagues,

Perioperative medicine covers a broad spectrum of diagnostic and therapeutic interventions needed to apply safe anaesthesia and perioperative care. Both functional and structural neurologic injury represent a serious risk of a compromised outcome, including increased morbidity and mortality and a decreased health-related quality of life among survivors. In recent years, there has been a growing interest in preventive measures and treatment strategies that could be implemented to reduce insults to the brain. Goal-directed therapy is recommended to all subjects at risk of neurologic complications. However, effective neuroprotection and adequate treatment are still in question.

This Special Issue seeks comprehensive high-quality manuscripts on clinical management of perioperative brain health in patients undergoing cardiac and noncardiac surgery, as well as in the critically ill. We welcome original research papers, systematic reviews, meta-analyses, and thorough reviews on this interesting topic. We hope that this Special Issue will provide up-to-date data that anesthesiologists and intensive care specialists worldwide can use to improve perioperative brain health.

Prof. Dr. Łukasz Krzych
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • perioperative medicine and the brain
  • prevention and treatment of perioperative neurological complications
  • neurological monitoring
  • perioperative cognitive disorders
  • brain injury prevention, assessment, and treatment
  • anaesthesia and the developing and aging brain
  • neuroprotection

Published Papers (3 papers)

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Research

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Open AccessArticle
Elevated Procalcitonin as a Risk Factor for Postoperative Delirium in the Elderly after Cardiac Surgery—A Prospective Observational Study
J. Clin. Med. 2020, 9(12), 3837; https://doi.org/10.3390/jcm9123837 - 26 Nov 2020
Viewed by 402
Abstract
One of the most common complications after cardiac surgery with cardiopulmonary bypass (CBP) is delirium. The purpose of this study was to prospectively investigate the risk of developing postoperative delirium in a group of elderly patients using a multivariate assessment of preoperative and [...] Read more.
One of the most common complications after cardiac surgery with cardiopulmonary bypass (CBP) is delirium. The purpose of this study was to prospectively investigate the risk of developing postoperative delirium in a group of elderly patients using a multivariate assessment of preoperative and intraoperative risk factors. A total of 149 elderly patients were included. Thirty patients (20%) developed post-operative delirium. Preoperative procalcitonin (PCT) above the reference range (>0.05 ng/mL) was recorded more often in patients who postoperatively developed delirium than in the non-delirium group (50% vs. 27%, p = 0.019). After surgery, PCT was significantly higher in the delirium than the non-delirium group: ICU admission after surgery: 0.08 ng/mL vs. 0.05 ng/mL p = 0.011), and for consecutive days (day 1: 0.59 ng/mL vs. 0.25 ng/mL, p = 0.003; day 2: 1.21 ng/mL vs. 0.36 ng/mL, p = 0.006; day 3: 0.76 ng/mL vs. 0.34 ng/mL, p = 0.001). Patients with delirium were older (74 vs. 69 years, p = 0.038), more often had impaired daily functioning (47% vs. 28%, p = 0.041), depressive symptoms (40% vs. 17%, p = 0.005), and anemia (43% vs. 19%, p = 0.006). In a multivariable logistic regression model, preoperative procalcitonin (odds ratio (OR) = 3.05), depressive symptoms (OR = 5.02), age (OR = 1.14), impaired daily functioning (OR = 0.76) along with CPB time (OR = 1.04) were significant predictors of postoperative delirium. Full article
(This article belongs to the Special Issue Clinical Management of Perioperative Brain Health)
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Review

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Open AccessReview
Delirium Superimposed on Dementia in Perioperative Period and Intensive Care
J. Clin. Med. 2020, 9(10), 3279; https://doi.org/10.3390/jcm9103279 - 13 Oct 2020
Viewed by 560
Abstract
Delirium is a life-threatening condition, the causes of which are still not fully understood. It may develop in patients with pre-existing dementia. Delirium superimposed on dementia (DSD) can go completely unnoticed with routine examination. It may happen in the perioperative period and in [...] Read more.
Delirium is a life-threatening condition, the causes of which are still not fully understood. It may develop in patients with pre-existing dementia. Delirium superimposed on dementia (DSD) can go completely unnoticed with routine examination. It may happen in the perioperative period and in the critical care setting, especially in the ageing population. Difficulties in diagnosing and lack of specific pharmacological and non-pharmacological treatment make DSD a seriously growing problem. Patient-oriented, multidirectional preventive measures should be applied to reduce the risk of DSD. For this reason, anesthesiologists and intensive care specialists should be aware of this interesting condition in their everyday clinical practice. Full article
(This article belongs to the Special Issue Clinical Management of Perioperative Brain Health)
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Open AccessReview
Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review
J. Clin. Med. 2020, 9(10), 3183; https://doi.org/10.3390/jcm9103183 - 30 Sep 2020
Cited by 1 | Viewed by 670
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Clinical Management of Perioperative Brain Health)
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