A multicomponent prehabilitation pathway to reduce the incidence of delirium in elderly patients in need of major abdominal surgery

__Background:__ Due to the increase in elderly patients who undergo major abdominal surgery there is a subsequent increase in postoperative complications, prolonged hospital stays, health-care costs and mortality rates. Delirium is

Capturing postural blood pressure dynamics with near-infrared spectroscopy-measured cerebral oxygenation

Orthostatic hypotension (OH) is highly prevalent in older adults and associated with dizziness, falls, lower physical and cognitive function, cardiovascular disease, and mortality. OH is currently diagnosed in a clinical setting with single-time point cuff measurements. Continuous blood pressure (BP) devices can measure OH dynamics but cannot be used for daily life monitoring. Near-infrared spectroscopy (NIRS) has potential diagnostic value in measuring cerebral oxygenation continuously over a longer time period, but this needs further validation. This study aimed to compare NIRS-measured (cerebral) oxygenation with continuous BP and transcranial Doppler-measured cerebral blood velocity (CBv) during postural changes. This cross-sectional study included 41 participants between 20 and 88 years old. BP, CBv, and cerebral (long channels) and superficial (short channels) oxygenated hemoglobin (O2Hb) were measured continuously during various postural changes. Pearson correlations between BP, CBv, and O2Hb were calculated over curves and specific characteristics (maximum drop amplitude and recovery). BP and O2Hb only showed good curve-based correlations (0.58–0.75) in the initial 30 s after standing up. Early (30–40 s) and 1-min BP recovery associated significantly with O2Hb, but no consistent associations were found for maximum drop amplitude and late (60–175 s) recovery values. Associations between CBv and O2Hb were poor, but stronger for long-channel than short-channel measurements. BP associated well with NIRS-measured O2Hb in the first 30 s after postural change. Stronger associations for CBv with long-channel O2Hb suggest that long-channel NIRS specifically reflects cerebral blood flow during postural transitions, necessary to better understand the consequences of OH such as intolerance symptoms

Correction to: Capturing postural blood pressure dynamics with near‑infrared spectroscopy‑measured cerebral oxygenation (GeroScience, (2023), 10.1007/s11357-023-00791-9)

In the article version originally published online, Table 2 was switched in the publication process. The correct version of Table 2 is shown below. (Table presented.) Heat map of average correlations for supine-stand and sit-stand transitions, during initial response (0-30 seconds after standing up) and late response (30-175 seconds after standing up) * Significantly different (p<0.05) between O2Hb-l and O2Hb-s. SBP Systolic blood pressure; DBP Diastolic blood pressure; MCAv Mean cerebral blood velocity in the middle cerebral artery; O2Hb-l Oxygenated hemoglobin measured with long channels; O2Hb-s Oxygenated hemoglobin measured with short channels; HHb-l Deoxygenated hemoglobin measured with long channels; HHb-s Deoxygenated hemoglobin measured with short channels