Recommendations for the Nomenclature of Cognitive Change Associated with Anaesthesia and Surgery—2018
2018/10/16 by L. Evered, Lisbeth Evered, Brendan Silbert +17 · 32 citations
Medicine · Neuroscience · #Intensive Care Unit Cognitive Disorders #Cardiac, Anesthesia and Surgical Outcomes #Anesthesia and Neurotoxicity Research
paper · pdf · doi:10.1097/aln.0000000000002334
Abstract
Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. The aim of this work is to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anaesthesia and surgery. A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions.Two major classification guidelines (Diagnostic and Statistical Manual for Mental Disorders, fifth edition [DSM-5] and National Institute for Aging and the Alzheimer Association [NIA-AA]) are used outside of anaesthesia and surgery, and may be useful for inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that 'perioperative neurocognitive disorders' be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).
Cited by
- Perioperative Neurocognitive Disorder
- Cognitive deficits after general anaesthesia in animal models: a scoping review
- Hippocampal endoplasmic reticulum stress drives a pro-inflammatory microglial bias and neuroinflammation in aged mice with perioperative neurocognitive disorder
- Best anaesthetic technique for prevention of postoperative cognitive dysfunction in older patients after hip fracture surgery – is the debate over?
- Neurocognitive outcomes: too much data, not enough clarity
- Development of a brief test protocol for assessing cognitive change in the peri‐operative period in older adults undergoing elective surgery
- Disruptions in RNA Splicing: A Key Regulator of Cognitive Impairment in Perioperative Neurocognitive Disorders
- Neurocognitive Function after Cardiac Surgery: From Phenotypes to Mechanisms. [europepmc]
- Best Practices for Postoperative Brain Health: Recommendations From the Fifth International Perioperative Neurotoxicity Working Group. [europepmc]
- Prevention of Early Postoperative Decline: A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training. [europepmc]
- Elamipretide (SS-31) improves mitochondrial dysfunction, synaptic and memory impairment induced by lipopolysaccharide in mice. [europepmc]
- Intraoperative Oxidative Damage and Delirium after Cardiac Surgery. [europepmc]
- Perioperative Neurocognitive Disorder: State of the Preclinical Science. [europepmc]
- Anesthetic Management Using Multiple Closed-loop Systems and Delayed Neurocognitive Recovery: A Randomized Controlled Trial. [europepmc]
- Dysregulation of BDNF/TrkB signaling mediated by NMDAR/Ca 2+ /calpain might contribute to postoperative cognitive dysfunction in aging mice. [europepmc]
- Dexmedetomidine Exerts an Anti-inflammatory Effect via α2 Adrenoceptors to Prevent Lipopolysaccharide-induced Cognitive Decline in Mice. [europepmc]
- Human plasma biomarker responses to inhalational general anaesthesia without surgery. [europepmc]
- Effects of electroencephalography and regional cerebral oxygen saturation monitoring on perioperative neurocognitive disorders: a systematic review and meta-analysis. [europepmc]
- Baicalin Ameliorates Cognitive Impairment and Protects Microglia from LPS-Induced Neuroinflammation via the SIRT1/HMGB1 Pathway. [europepmc]
- The Effect and Optimal Dosage of Dexmedetomidine Plus Sufentanil for Postoperative Analgesia in Elderly Patients With Postoperative Delirium and Early Postoperative Cognitive Dysfunction: A Single-Center, Prospective, Randomized, Double-Blind, Controlled Trial. [europepmc]
- Sirtuin 3 protects against anesthesia/surgery-induced cognitive decline in aged mice by suppressing hippocampal neuroinflammation. [europepmc]
- Inhaled Anesthetics: Environmental Role, Occupational Risk, and Clinical Use. [europepmc]
- The Role of Microglia in Perioperative Neuroinflammation and Neurocognitive Disorders. [europepmc]
- Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction. [europepmc]
- Sleep, Pain, and Cognition: Modifiable Targets for Optimal Perioperative Brain Health. [europepmc]
- Metabolic reprogramming mediates hippocampal microglial M1 polarization in response to surgical trauma causing perioperative neurocognitive disorders. [europepmc]
- Neuroinflammation as the Underlying Mechanism of Postoperative Cognitive Dysfunction and Therapeutic Strategies. [europepmc]
- Effect of Subanesthetic Dose of Esketamine on Perioperative Neurocognitive Disorders in Elderly Undergoing Gastrointestinal Surgery: A Randomized Controlled Trial. [europepmc]
- Blood tau-PT217 contributes to the anesthesia/surgery-induced delirium-like behavior in aged mice. [europepmc]
- Smad7 in the hippocampus contributes to memory impairment in aged mice after anesthesia and surgery. [europepmc]
- Impaired synaptic plasticity and decreased glutamatergic neuron excitability induced by SIRT1/BDNF downregulation in the hippocampal CA1 region are involved in postoperative cognitive dysfunction. [europepmc]
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery. [europepmc]
Related