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Abstract
Perioperative neurocognitive disorders (PND) after cardiac surgery occur in a significant number of patients and negatively impact recovery and long-term outcomes.
- The causes of PND are complex and involve factors such as reduced blood flow to the brain, small blood clots, inflammation related to surgery, and disruptions to the blood-brain barrier.
- Current biomarker categories include those related to nerve and brain cell injury, inflammation, oxidative stress, and metabolic imbalances.
- Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) have some clinical evidence supporting their use as biomarkers, but none are yet suitable for routine clinical application.
- Most biomarkers tested have shown limited ability to distinguish between patients who will and will not develop PND when used alone.
- Candidate biomarkers may have potential value, but few have improved risk assessment beyond traditional factors such as age and preexisting cognitive conditions.
- Future studies should focus on standardizing definitions and methods, validating findings across multiple centers, and developing models for specific clinical applications.
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