Delirium in cardiac surgery - risk factors and prevention

Introduction. Delirium is defined as an acute change in mental status that leads to disturbance perception, thinking, memory, attention, emotional status, well sleep rhythm disorders and most often reversible. Postoperative delirium disorder develops after cardiovascular surgery with incidence of 20 - 50% operated patients. This complication associated a longer hospitalization, stay the intensive care unit, increased morbidity mortality. Risk Factors. The risk factors are divided into preoperative, intraoperative postoperative. common preoperative older age, stenosis carotid arteries, previous cerebral diseases, depression, diabetes, hypertension, low ejection fraction left ventricle, heart disorders. Intraoperative include type surgery, anesthesia, duration extracorporeal circulation, aortic clamp. important postoperative use psychoactive drugs, prolonged pain, opioid mechanical ventilation, length unit. Prevention. Prevention very aspect focused on precipitating factors. Preventive treatment includes pharmacological non-pharmacological methods. main recommendation refers avoiding routine antipsychotics. Conclusion. Continuous infusion dexmedetomidine compared propofol reduces delirium. Nonpharmacological approach consists series procedures carried out postoperatively, such protocol monitoring Awakening, Breathing, Coordination, Delirium, Early mobility, Family engagement.