The association of plasma gamma-aminobutyric acid concentration with postoperative delirium in critically ill patients

Shiho Yoshitaka, Moritoki Egi, Tomoyuki Kanazawa, Yuichiro Toda, Kiyoshi Morita

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Objective: Delirium is a common complication in postoperative, critically ill patients. The mechanism of postoperative delirium is not well understood but many studies have shown significant associations between benzodiazepine use, alcohol withdrawal and cirrhosis, and an increased risk of delirium. We aimed to investigate a possible link with alterations of gamma-aminobutyric acid (GABA) activity. Design, setting and participants: A prospective observational investigation of 40 patients > 20 years old who had undergone elective surgery with general anaesthesia and were expected to need postoperative intensive care for more than 48 hours. We assessed postoperative delirium using the confusion assessment method in the intensive care unit at 1 hour after the operation and on postoperative Day (POD) 1 and POD 2. We collected blood samples for measurement of plasma GABA concentrations before the operation and on POD 1 and 2. Main outcome measures: Postoperative delirium and perioperative plasma GABA concentrations in patients with and without delirium. Results: Postoperative delirium occurred in 13 of the patients. Patients with delirium had significantly higher Acute Physiology and Chronic Health Evaluation II scores than patients without delirium. The mean plasma GABA concentration on POD 2 was significantly lower in patients with delirium than in those without delirium. After adjustment of relevant variables, plasma GABA concentration on POD 2 was independently associated with postoperative delirium. Conclusions: Plasma GABA level on POD 2 has a significant independent association with postoperative delirium.

Original languageEnglish
Pages (from-to)269-273
Number of pages5
JournalCritical Care and Resuscitation
Issue number4
Publication statusPublished - Dec 1 2014

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine
  • Anesthesiology and Pain Medicine


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