# Long-chain polyunsaturated fatty acid lipid and oxylipin alterations in postoperative delirium after cardiac surgery

## TL;DR

This study found that changes in certain lipids and oxylipins are linked to postoperative delirium after heart surgery, and that a drug called dexmedetomidine may help reduce these changes.

## Contribution

The study identifies specific lipidomic and oxylipin alterations associated with postoperative delirium and their modulation by dexmedetomidine.

## Key findings

- Cardiac surgery is associated with decreased serum lysophospholipids.
- Postoperative delirium is linked to increased long-chain polyunsaturated fatty acid phospholipids and elevated oxylipins.
- Dexmedetomidine reduces long-chain polyunsaturated fatty acid phospholipid levels.

## Abstract

Lipids play a crucial role in signaling, membrane dynamics, and inflammatory regulation, yet their involvement in postoperative delirium pathogenesis remains unclear. This study examined serum lipidomic alterations in postoperative delirium and assessed the effects of dexmedetomidine treatment on these changes. Lipidomic profiling was conducted at baseline and postoperative day 1 in two independent cohorts of cardiac surgery patients. Mass spectrometry-based shotgun lipidomics and targeted lipid analyses were used to assess lipidomes and oxylipins, respectively. Cardiac surgery was associated with decreased serum lysophospholipids. Postoperative delirium was associated with increased long-chain polyunsaturated fatty acid phospholipids, particularly phosphatidylethanolamines, and elevated oxylipins. Dexmedetomidine, a potential delirium-mitigating medication, reduced long-chain polyunsaturated fatty acid phospholipids. These findings highlight lipid modulation as a potential target for postoperative delirium prevention.