PMID- 37773821
OWN - NLM
STAT- MEDLINE
DCOM- 20231005
LR  - 20231005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 39
DP  - 2023 Sep 29
TI  - Role of hypoxia-inducible factor in postoperative delirium of aged patients: A 
      review.
PG  - e35441
LID - 10.1097/MD.0000000000035441 [doi]
LID - e35441
AB  - Postoperative delirium is common, especially in older patients. Delirium is 
      associated with prolonged hospitalization, an increased risk of postoperative 
      complications, and significant mortality. The mechanism of postoperative delirium 
      is not yet clear. Cerebral desaturation occurred during the maintenance period of 
      general anesthesia and was one of the independent risk factors for postoperative 
      delirium, especially in the elderly. Hypoxia stimulates the expression of 
      hypoxia-inducible factor-1 (HIF-1), which controls the hypoxic response. HIF-1 
      may have a protective role in regulating neuron apoptosis in neonatal 
      hypoxia-ischemia brain damage and may promote the repair and rebuilding process 
      in the brain that was damaged by hypoxia and ischemia. HIF-1 has a 
      neuroprotective effect during cerebral hypoxia and controls the hypoxic response 
      by regulating multiple pathways, such as glucose metabolism, angiogenesis, 
      erythropoiesis, and cell survival. On the other hand, anesthetics have been 
      reported to inhibit HIF activity in older patients. So, we speculate that HIF 
      plays an important role in the pathophysiology of postoperative delirium in the 
      elderly. The activity of HIF is reduced by anesthetics, leading to the inhibition 
      of brain protection in a hypoxic state. This review summarizes the possible 
      mechanism of HIF participating in postoperative delirium in elderly patients and 
      provides ideas for finding targets to prevent or treat postoperative delirium in 
      elderly patients.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Shen, Hu
AU  - Shen H
AD  - Department of Neurology, Sichuan Provincial People's Hospital, School of 
      Medicine, University of Electronic Science and Technology of China, Chengdu, 
      China.
FAU - Yang, Jianyin
AU  - Yang J
AD  - Department of ICU, Chengdu Xinjin District Hospital of Traditional Chinese 
      Medicine, Chengdu, China.
FAU - Chen, Xu
AU  - Chen X
AUID- ORCID: 0000-0003-0722-5918
AD  - Department of Pharmacy, Chengdu Women's and Children's Central Hospital, School 
      of Medicine, University of Electronic Science and Technology of China, Chengdu, 
      China.
FAU - Gao, Yu
AU  - Gao Y
AD  - Department of Pharmacy, Chengdu Women's and Children's Central Hospital, School 
      of Medicine, University of Electronic Science and Technology of China, Chengdu, 
      China.
FAU - He, Baoming
AU  - He B
AUID- ORCID: 0009-0003-6589-5335
AD  - Department of Neurology, Sichuan Provincial People's Hospital, School of 
      Medicine, University of Electronic Science and Technology of China, Chengdu, 
      China.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Transcription Factors)
RN  - 0 (Anesthetics)
RN  - 0 (Hypoxia-Inducible Factor 1, alpha Subunit)
SB  - IM
MH  - Infant, Newborn
MH  - Humans
MH  - Aged
MH  - *Emergence Delirium
MH  - Transcription Factors/metabolism
MH  - Hypoxia
MH  - Ischemia
MH  - *Anesthetics
MH  - Hypoxia-Inducible Factor 1, alpha Subunit
PMC - PMC10545271
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2023/09/29 18:42
MHDA- 2023/10/05 06:43
PMCR- 2023/09/29
CRDT- 2023/09/29 15:44
PHST- 2023/10/05 06:43 [medline]
PHST- 2023/09/29 18:42 [pubmed]
PHST- 2023/09/29 15:44 [entrez]
PHST- 2023/09/29 00:00 [pmc-release]
AID - 00005792-202309290-00039 [pii]
AID - 10.1097/MD.0000000000035441 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Sep 29;102(39):e35441. doi: 
      10.1097/MD.0000000000035441.