Key result
Intraoperative hypotension shows conflicting associations with postoperative cognitive decline and delirium.
Why the study?
Perioperative neurocognitive disorders after cardiac surgery significantly contribute to morbidity and mortality, and the role of intraoperative hypotension as a modifiable risk factor remains unclear due to heterogeneous and divergent study results.
Does intraoperative hypotension increase the risk of postoperative neurocognitive disorders in patients undergoing cardiac surgery?
Systematic Review
Does intraoperative hypotension increase the risk of postoperative neurocognitive disorders in patients undergoing cardiac surgery?
The current evidence regarding the association between intraoperative hypotension and postoperative neurocognitive disorders in cardiac surgery is highly heterogeneous with divergent results.
Evidence too heterogeneous for clinical conclusions on intraoperative hypotension and neurocognitive decline; leaves open need for standardized prospective trials.
Perioperative neurocognitive disorders remain a challenging obstacle in patients after cardiac surgery, as they significantly contribute to postoperative morbidity and mortality. Identifying the modifiable risk factors and mechanisms for postoperative cognitive decline (POCD) and delirium (POD) would be an important step forward in preventing such adverse events and thus improving patients' outcome. Intraoperative hypotension is frequently discussed as a potential risk factor for neurocognitive decline, due to its significant impact on blood flow and tissue perfusion, however the studies exploring its association with POCD and POD are very heterogeneous and present divergent results. This review demonstrates 13 studies found after structured systematic search strategy and discusses the possible relationship between intraoperative hypotension and postoperative neuropsychiatric dysfunction.
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Czok et al. (2021) conducted a systematic review in Postoperative neurocognitive disorders after cardiac surgery. Intraoperative hypotension was evaluated on Postoperative cognitive decline (POCD) and delirium (POD). Intraoperative hypotension's association with postoperative cognitive decline and delirium was evaluated across 13 heterogeneous studies, which presented divergent results.
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