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πŸ§ πŸ’­ β€œMind the Fog” β€” Unmasking POCD Across Ages πŸ’‰πŸ”¬ #MindTheFog #POCD #BrainProtection #RegionalAnesthesia #CognitiveRecovery #PainMatters #Neuroinflammation #SodiumChannels #ElderlyCare #TipOfTheDay #MyRATips Tip of the Day: πŸ” What is POCD? β€’ Decline in memory, attention, and executive function after surgery β€’ Can be short-term or long-lasting β€’ Most common in the elderly but affects all age groups πŸ‘΅πŸ‘Ά POCD Across Age Groups πŸ§“ Elderly: Highest risk; due to reduced neural plasticity and high inflammation πŸ‘¨β€πŸ¦± Middle-aged: Moderate, often reversible; worsened by comorbidities πŸ§’ Children: Rare POCD; emergence delirium more common πŸ’₯🧠 Pain-Induced Cognitive Dysfunction πŸ”₯ Pain triggers IL-1Ξ², TNF-Ξ± β†’ neuroinflammation πŸ’‘ Chronic pain increases cortisol β†’ disrupts memory 🧬 Glutamate overdrive β†’ NMDA receptor fatigue ⚑ Na⁺ channel upregulation (NaV1.7, 1.8, 1.9) β†’ cortical hyperexcitability 🧠 Affects hippocampus and prefrontal cortex β†’ mimics POCD βš™οΈ Core Mechanisms of POCD 🧠 Neuroinflammation via glial activation πŸ›‘οΈ BBB breakdown β†’ toxin entry into CNS ☠️ Volatile agent toxicity β†’ amyloid, tau changes πŸ’§ Hypoperfusion β†’ ischemic brain injury 🧴 Cholinergic suppression β†’ reduced attention πŸ”Œ Na⁺ channel overactivity β†’ neural overload πŸ’‰ Regional Anesthesia: Cognitive Guardian 🩻 Avoids volatile anesthetics πŸ”‡ Blunts nociceptive input β†’ less inflammation πŸ’Š Reduces opioids β†’ lowers delirium risk 🌑️ Stabilizes hemodynamics β†’ protects perfusion 🚫 Blocks Na⁺ channels peripherally β†’ prevents central hyperexcitability πŸ”„ Improves sleep, reduces ICU needs πŸ’Š What Helps? βœ… Effective Agents 🧠 Dexmedetomidine: Sedative anti-inflammatory, reduces POCD πŸŒ™ Melatonin / Ramelteon: Restores circadian rhythm, reduces delirium ⚠️ Use with Caution 🧯 Haloperidol: For agitation only; not preventive, may cause side effects πŸ§ πŸ“ˆ Monitoring & Prevention β€’ πŸ“‹ Screen with MMSE / MoCA preoperatively β€’ 🩹 Prefer RA in elderly and high-risk surgeries β€’ 🎯 Avoid deep sedation; use BIS or EEG to titrate β€’ πŸ’Š Use opioid-sparing multimodal analgesia β€’ πŸ›οΈ Encourage early mobilization and sleep hygiene β€’ πŸ‘¨β€πŸ‘©β€πŸ‘¦ Use clocks, windows, family for orientation 🎯 Take-Home Message POCD is predictable and preventable - driven by pain, inflammation, and Na⁺ channel dysfunction. πŸ“Œ Treat pain early. πŸ“Œ Choose RA when possible. πŸ“Œ Use brain-friendly drugs. 🧠 Preserve the mind βœ… Empower recovery 🎯 Think ahead. πŸ“Œ Block the pain. πŸ§˜β€β™‚οΈ Calm the brain. πŸ’‘ Mind the fog.
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Replying to @DivineManhood
Hydration matters! I realized I was often dehydrated, affecting my concentration. Drinking enough water has made my thoughts clearer and headaches rarer. Your brain loves waterβ€”don’t forget it! πŸ’§βœ¨ #BrainProtection #StayHydrated
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Inside the skull, the brain is covered in layers of connective tissue for extra protection🧠πŸ’ͺThe outermost layer, dura mater or 'tough mother,' lives up to its cool name in that it's so thick, it actually feels tough, like leather. Cool, a leather bag to carry your brain in. ⚠Graphic link: Exposed dura mater inside human skull bit.ly/3TcGvEV Image credit: bit.ly/3wS5zda #brainprotection #neuroanatomy #meninges
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Depth of anaesthesia monitoring is recommended for improving haemodynamics and neurological outcomes. @StefanoRomagno9 in #WCA2024 speaking on this subject. #brainprotection
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Here's how the brain protects itself from blood-borne threats. 🧠 #Brain #Neuroscience #Blood #Biology #Physiology #BrainProtection quantamagazine.org/how-the-b… @QuantaMagazine
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8 Jun 2023
Well done to the cardiac research team at @HullHospitals for randomising their first this morning πŸ₯³ - that's 138 participants in @co2study now - brilliant work from all our sites #clinicalresearch #brainprotection #insufflation @BrsTrialsCentre @bengibbison
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22 Dec 2022
As 2022 comes to a close, we want to say a huge thanks to the wonderful research teams and participants taking part in the @co2study, we could not do it without you. πŸ‘πŸ‘πŸ‘ Have a safe and happy festive period and and even better 2023 πŸ₯³πŸŽ…πŸ§ #clinicaltrials #brainprotection

ALT Christmas Thank You GIF by Vimodji

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19 Dec 2022
Early present from the lovely @OUH_Research team who just randomised the 90th @co2study participant, amazing work!! πŸ₯³πŸ‘πŸŽ…#clinicalresearch #brainprotection @BrsTrialsCentre @bengibbison @OUHospitals .... who will get the 100th?!?
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23 Nov 2022
Want to design Halos for your team? In your team colours? You can #makeityours here rezonwear.com/product/halos-… #brainprotection #cte #chronictraumaticencephalopathy #braininjury
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21 Nov 2022
Sport does so much good - now let's protect the brains of players as much as we protect the rest of their bodies, so that they can perform at their very best in life as well as in sport. rezonwear.com/ #cte #braininjury #brainprotection #chronictraumaticencephalopathy
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Do you know how ARG-007 works? Our recent Investor Presentation gives a breakdown of how it protects your brain during a stroke. View the full presentation here: bit.ly/36MeCzr #AGN #ASX #ARG007 #stroke #brainprotection #strokeresearch
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Eureka: Meet Judith McMinn, the innovator tackling the silent killer of contact sports head on with the creation of @rezonwear’s innovative #brainprotection device, the #halo. fal.cn/3sKnd

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22 Sep 2022
What causes #CTE? What are sub-concussions? Here Judith McMinn, CEO and founder of Rezon, speaks with @Ladyannafoster on @bbcnewcastle. Every player, coach and parent should take 25 mins to listen. youtube.com/watch?v=eBtE44Y_… #brainprotection
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23 Aug 2022
Time for a Tuesday #happydance!! @BHIBristol have just gone and recruited the 50th @co2study participant, closely followed by the 51st from @UHSFT. Huge well done to our recruiting sites for your hard work πŸ‘πŸ‘πŸ‘ @bengibbison @BrsTrialsCentre #brainprotection #ClinicalTrials

ALT Claire Dancing GIF

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6 Jun 2022
@UHP_NHS are smashing it having just randomised their 1st @co2study participant and not even been open a week, well done guys!! πŸŽ‰πŸ‘πŸŽŠ Also that was the 20th participant to be randomised into @co2study 🧠πŸ₯³πŸ€œ#research #brainprotection @BrsTrialsCentre @bengibbison
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