Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions

Momeni, Mona; Meyer, Scott C.; Docquier, Marie-Agnès; Lemaire, Guillaume; Kahn, David; Khalifa, Céline; Martins, Maria Rosal; Dyck, Michel Van; Jacquet, Luc‐Marie; Peeters, André; Watremez, Christine

doi:10.1007/s10877-019-00253-8

Cited by 45 publications

(43 citation statements)

References 44 publications

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“…In the December issue of the journal, Momeni et al [25] published a large prospective observational study of 1.616 patients having cardiac interventions with or without general anesthesia, the majority having cardiac surgery. The aim of the study was to investigate the impact of electroencephalogram (EEG) suppression as assessed with a depth-of-anesthesia (DoA) monitor, and decreased cerebral rSO 2 on the incidence of postoperative delirium and cognitive dysfunction (POCD).…”

Section: Near-infrared Spectroscopy (Nirs) For Monitoring Cerebral Anmentioning

confidence: 99%

Journal of Clinical Monitoring and Computing 2019 end of year summary: monitoring tissue oxygenation and perfusion and its autoregulation

Sahinovic

Vos

Scheeren

2020

J Clin Monit Comput

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Tissue perfusion monitoring is increasingly being employed clinically in a non-invasive fashion. In this end-of-year summary of the Journal of Clinical Monitoring and Computing, we take a closer look at the papers published recently on this subject in the journal. Most of these papers focus on monitoring cerebral perfusion (and associated hemodynamics), using either transcranial doppler measurements or near-infrared spectroscopy. Given the importance of cerebral autoregulation in the analyses performed in most of the studies discussed here, this end-of-year summary also includes a short description of cerebral hemodynamic physiology and its autoregulation. Finally, we review articles on somatic tissue oxygenation and its possible association with outcome.

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Section: Near-infrared Spectroscopy (Nirs) For Monitoring Cerebral Anmentioning

confidence: 99%

Journal of Clinical Monitoring and Computing 2019 end of year summary: monitoring tissue oxygenation and perfusion and its autoregulation

Sahinovic

Vos

Scheeren

2020

J Clin Monit Comput

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“…9 In contrast to the overwhelming data showing harmful health consequences of cigarette smoking, surprisingly, some studies have shown better survival outcome among smokers (e.g., prior-smokers or current-smokers) compared with never-smokers, a phenomenon called "smoking paradox." The smoking paradox is mainly observed among certain groups of patients, including patients with acute myocardial infarction (AMI), [10][11][12][13][14][15][16][17][18][19][20][21] heart failure, 22 CAD or acute cerebral stroke, [23][24][25] and among patients who underwent cardiopulmonary resuscitation for inhospital cardiac arrest. 26 Moreover, tobacco smoking showed to be an independent protective predictor of adverse left ventricle-remodeling among patients with AMI.…”

Section: Introductionmentioning

confidence: 99%

Impact of baseline cigarette smoking status on clinical outcome after transcatheter aortic valve replacement

Abawi

Gils

Agostoni

et al. 2019

Cathet Cardio Intervent

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Objectives To explore the prevalence of smoking, and its association with clinical and mortality outcome among patients undergoing transcatheter aortic valve replacement (TAVR). Background Less data exist regarding the effect of baseline smoking status on clinical and mortality outcome among patients undergoing TAVR. Methods Consecutive patients who underwent TAVR at two high volume Dutch centers were included. Smoking status was prospectively questioned by a structured interview at admission. Primary endpoint was 1‐year all‐cause mortality after TAVR. Results A total of 913 consecutive patients (80.1 ± 7.6 years; logistic EuroSCORE: 16.5 ± 9.9%) who underwent TAVR for severe aortic valve stenosis were included. There were 47% (n = 432) males, and 57% (n = 522) never‐smokers, and 35% (n = 317) prior‐smokers, and 8% (n = 74) current‐smokers. Smokers (i.e., prior‐smokers or current‐smokers) were younger compared to never‐smokers (78.9 ± 7.9 and 76.4 ± 8.0 vs. 81.3 ± 7.1, P < 0.000, respectively). Median follow‐up time was 365 (interquartile range [IQR]: 280–365) days. Overall, prior‐smoking was not associated with all‐cause mortality at 1‐year following TAVR (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.55–1.23). After stratification according to sex, male prior‐smokers showed better 1‐year survival after TAVR than male never‐smokers (12% vs. 20%; P = 0.018, respectively, HR 0.52, 95% CI 0.29–0.89), while this reversed effect was not observed among female prior‐smokers versus female never‐smokers after TAVR (HR 1.70, 95% CI 0.95–3.05). Conclusions Overall, baseline prior‐smokers had similar 1‐year mortality outcome after TAVR compared with baseline never‐smokers. However, there was a reversed association between baseline prior‐smoking status and 1‐year mortality after TAVR among males, which could partially be explained due to the favorable baseline characteristics.

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“…Intraoperative regional cerebral oxygen saturation (rSO 2 ), measured by near-infrared spectroscopy, may also play a role in postoperative neurological functioning. Prolonged desaturations in the brain have been associated with poor neurological outcome, as well as delirium, and active monitoring to prevent significant drops in rSO 2 may prevent these complications 11 12. Intraoperative rSO 2 monitoring has gradually become regular practice in many hospitals, yet the supporting evidence is lacking in quality 13 14.…”

Section: Introductionmentioning

confidence: 99%

Road to recovery: a study protocol quantifying neurological outcome in cardiac surgery patients and the role of cerebral oximetry

et al. 2019

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IntroductionPatients undergoing cardiac surgery may experience both short-term and long-term postoperative neurological problems. However, the underlying cause of this impairment is unclear. Regional cerebral oxygen saturation (rSO2) levels may play a role in the development of acute dysfunction, known as postoperative delirium, in addition to longer term outcomes after cardiac surgery. Yet the degree of impairment has been difficult to define, partly due to subjective methods of assessments. This study aims to fill this knowledge gap by determining the relationship between rSO2, postoperative delirium and long-term neurological outcome after cardiac surgery using quantitative robotic technology.Methods and analysis95 patients scheduled for elective cardiac surgery will be recruited for this single-centre prospective observational study. Patients will be assessed before as well as 3 and 12 months after their surgery using the Kinarm End-Point Lab and standardised tasks. Intraoperatively, rSO2 and other haemodynamic data will be collected for the duration of the procedure. Following their operation, patients will also be screened daily for delirium during their hospital stay.Ethics and disseminationThis study has been approved by the Health Sciences Research Ethics Board at Queen’s University (DMED-1672–14). The results of this study will be published in a peer-review journal and presented at international and/or national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.Trial registration number NCT04081649

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Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions

Cited by 45 publications

References 44 publications

Journal of Clinical Monitoring and Computing 2019 end of year summary: monitoring tissue oxygenation and perfusion and its autoregulation

Journal of Clinical Monitoring and Computing 2019 end of year summary: monitoring tissue oxygenation and perfusion and its autoregulation

Impact of baseline cigarette smoking status on clinical outcome after transcatheter aortic valve replacement

Road to recovery: a study protocol quantifying neurological outcome in cardiac surgery patients and the role of cerebral oximetry

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