In a cohort of 400 cardiac surgery patients, intraoperative plasma concentrations of F2-isoprostanes and isofurans (markers of oxidative damage) were independently associated with both increased postoperative delirium and increased plasma concentrations of ubiquitin carboxyl-terminal hydrolase isozyme L1, a marker of neuronal injury.The association between increased systemic markers of oxidative damage and increased neuronal injury was stronger in patients with elevated plasma S100 calcium-binding protein B, a marker of blood-brain barrier disruption.