Episode 338: Post-op Delirium With Michelle Humeidan

Post-operative delirium ranks as the most common complication for older surgical patients, occurring in 20-25% of elective cases and up to 60% of cardiac or vascular procedures. This condition arises from multifactorial stressors, including systemic inflammation, surgical invasiveness, and diminished patient cognitive reserve. Dr. Michelle Humeidan, a neuroanesthesiologist at The Ohio State University, advocates for proactive identification of preoperative cognitive impairment using brief screening tools like the mini-cog. Clinical management strategies prioritize minimizing benzodiazepine exposure, utilizing dexmedetomidine, and implementing sensory aids to maintain orientation. Emerging research, including the multi-center SCOPE trial, investigates cognitive prehabilitation through dynamic brain exercises as a low-risk intervention to bolster mental reserve. These layered approaches aim to mitigate acute delirium and prevent long-term cognitive decline, shifting the perioperative focus toward optimizing brain health alongside traditional organ-system management.