This research aims at describing the relationship between white adipose tissue inflammation and post-operative cognitive dysfunctions.The possible link between inflammatory cytokines secretions of the white adipose tissue of a surgical wound and the arising of patient's cognitive dysfunction in the post-operative course will be investigated. The hypothesis is that obese patient's inflammation of the white adipose tissue leads to cognitive dysfunction.
The postoperative cognitive dysfunctions (POCD) are characterized by delirium and cognitive impairment. The delirium is defined by an acute altered attention with a fluctuating course. The post-operative cognitive impairment involves the early alteration of different functions including memory, attention and cognitive flexibility. POCD have a major impact in patient's morbidity. They are linked to the systemic inflammation induced by the surgical wound. The systemic inflammation leads to the rupture of the brain-blood barrier and to hippocampal inflammation. As hippocampus mediates the principal cognitive functions, hippocampal inflammation leads to POCD. Orthopedic and cardiac surgery are particularly concerned. Obesity is growing condition in the French population. It is linked to chronic systemic inflammation and altered cognitive functions. We think that obese people may present a susceptibility to POCD because of the pre-operative systemic inflammation.
Study Type
OBSERVATIONAL
Enrollment
115
4 tubes of 7 mL of blood will be collected
At the beginning of the surgery, samples of white adipose tissue from the surgical wound will be collected.
Purpan University Hospital
Toulouse, France
Arising of POCD measured by a composite criterion
2 points Mini-Mental State Examination (MMSE) score decrease compared to the pre-operative score, and/or appearance of a delirium tracked down every day by the Confusion Assessment Method (CAM) during the hospital course.
Time frame: day 5 after surgery
Variation of inflammatory cytokine levels from patient's plasma and patient's white adipose tissue (extract from a controlled medium).
inflammatory cytokine levels will be measured in plasma and adipose tissue, and compared.
Time frame: Day 0 and day 5 after surgery
Identification of a linked between inflammatory cytokine levels and the appearance of POCD.
inflammatory cytokine levels will be measured in plasma and adipose tissue, and correlated with appearance of POCD
Time frame: day 5 after surgery
Peri-operative variations of the protein S100B, an autonomy scale (IADL) and a quality of life scale (EQ5D).
protein S100B levels will be measured in plasma and adipose tissue, and correlated with scores of autonomy scale (IADL) and quality of life scale (EQ5D).
Time frame: day 5 after surgery
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