The prevalence of delirium after open heart surgery and the efficacy of dexmedetomidine

Abstract

Objective: Delirium is the most common neurological complication encountered after heart surgery. Studies have reported different prevalence results due to factors as varying detection tools, and diagnostic criteria. In our study we wanted to investigate the prevalence of delirium, predisposing factors and the effect of dexmedetomidine on therapy. Material and Methods: After the approval,of the Educational Planning Committee 30 patients who were diagnosed with delirium were selected as the study group and 1165 patients as the control, group. Turkish version of The Confusion Assessment Scale (CAM-ICU) was used tostablish diagnosis of delirium and dexmedetomidine therapy was started. Patients' demographic characteristics, length of surgery, the amount of blood and fluid, used,presence of inotropic support, extubati- on, length of stay in ICU and hospital were recorded. Statistics: Kolmogorov-Smirnov test was used for normal distribution, Pearson chi-square test and Fishers exact test were used for qualitative datas. Mann- Whitney U test was used for the assessment of quantitave parameters. Results: In our study, after dexmetodomine, symptomatic regression was observed in 80% of the patients. Age, use of notropic drugs, duration of surgey and cross-clamp time, the amount of blood, and fluitl used, were predisposing factors. The ICU and hospital stays were longer in Group D (7.5±8 >2,9±1 days ICU, 14,7±9>9,6±3 HLOS), Conclusion: We found the frequency of delirium as 2.5 percent. Hypertension, duration of surgery and cross-clamp, excess amounts of blood products used were found as risk factors (p<0.05). We think that; addition of CAM-ICU to routine daily follow-up forms may provide early diagnosis and appropriate treatment of delirium. Dexmedotomidine appears to be a convenient and useful choice for therapy of delirium.