{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:01:00Z","timestamp":1775181660043,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>In elderly patients undergoing cardiac surgery, extracorporeal circulation affects the incidence of post-operative delirium and cognitive impairment with an impact on quality of life and mortality. In this study, a new oxygenator system (RemoweLL 2) was tested against a conventional system to assess its efficacy in reducing the onset of postoperative delirium and cognitive dysfunction and the levels of serum inflammatory markers. A total of 154 patients (&gt;65 y.o.) undergoing cardiopulmonary bypass (CPB) were enrolled and randomly assigned to oxygenator RemoweLL 2 (n = 81) or to gold standard device Inspire (n = 73) between September 2019 and March 2022. The aims of the study were to assess the incidence of delirium and the cognitive decline by neuropsychiatric tests and the MoCa test intra-hospital and at 6 months after CPB. Inflammation biomarkers in both groups were also evaluated. Before the CPB, the experimental groups were comparable for all variables. After CPB, the incidence of severe post-operative delirium showed a better trend (p = 0.093) in patients assigned to RemoweLL 2 (16.0%) versus Inspire (26.0%). Differences in enolase levels (p = 0.049), white blood cells (p = 0.006), and neutrophils (p = 0.003) in favor of RemoweLL 2 were also found. The use of novel and better construction technologies in CPB oxygenator devices results in measurable better neurocognitive and neurological outcomes in the elderly population undergoing CPB.<\/jats:p>","DOI":"10.3390\/bioengineering10121429","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T11:26:52Z","timestamp":1702639612000},"page":"1429","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Post-Operative Delirium and Cognitive Dysfunction in Aged Patients Undergoing Cardiac Surgery: A Randomized Comparison between Two Blood Oxygenators"],"prefix":"10.3390","volume":"10","author":[{"given":"Lorenzo","family":"Mantovani","sequence":"first","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2892-8700","authenticated-orcid":false,"given":"Elisa","family":"Mikus","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6974-0849","authenticated-orcid":false,"given":"Elena","family":"Tenti","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Sangiorgi","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Zannoni","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Cavallucci","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-4105","authenticated-orcid":false,"given":"Letizia","family":"Ferroni","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3326-7663","authenticated-orcid":false,"given":"Paolo","family":"Cimaglia","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Tolio","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Tremoli","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4197-7486","authenticated-orcid":false,"given":"Carlo","family":"Savini","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, 48031 Cotignola, Italy"},{"name":"Department of Experimental Diagnostic and Surgical Medicine (DIMEC), University of Bologna, 40126 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1016\/j.jacc.2022.02.027","article-title":"Origins and Evolution of Extracorporeal Circulation","volume":"79","author":"Holman","year":"2022","journal-title":"J. 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