Cerebral oximetry as a biomarker of postoperative delirium in cardiac surgery patients

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• 作者：Tanya Mailhot ; RN ; PhD (candidate)^a ; ^b ; ^{t.mailhot@umontreal.ca" class="auth_mail" title="E-mail the corresponding author} ; Sylvie Cossette ; RN ; PhD^a ; ^b ; ^{sylvie.cossette.inf@umontreal.ca" class="auth_mail" title="E-mail the corresponding author} ; Jean Lambert ; PhD^c ; ^d ; ^{Jean.lambert@umontreal.ca" class="auth_mail" title="E-mail the corresponding author} ; Alexis Cournoyer ; MD^e ; ^{alexis.cournoyer@umontreal.ca" class="auth_mail" title="E-mail the corresponding author} ; André ; Y. Denault ; MD ; PhD^e ; ^f ; ^{andre.denault@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cerebral oximetry ; Spectroscopy ; Near-infrared ; Delirium ; Thoracic surgery ; Postoperative complications
• 刊名：Journal of Critical Care
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：34
• 期：Complete
• 页码：17-23
• 全文大小：396 K

文摘

A promising monitoring strategy for delirium is the use of cerebral oximetry, but its validity during delirium is unknown. We assessed the relationship between oximetry and delirium. We hypothesized that as cerebral oximetry values increased, delirium would resorb.

Materials and methods

An observational study was conducted with 30 consecutive adults with delirium after cardiac surgery. Oximetry, delirium assessments, and clinical data were collected for 3 consecutive days after delirium onset. Oximetry was obtained using near-infrared spectroscopy. Delirium was assessed using diagnosis, occurrence (Confusion Assessment Method-ICU), and severity scales (Delirium Index).

Results

All patients presented delirium at entry. The mean oximetry value decreased from 66.4 ± 6.7 (mean ± SD) to 50.8 ± 6.8 on the first day after delirium onset and increased in patients whose delirium resorbed over the 3 days. The relationship between oximetry, delirium diagnosis, and severity was analyzed with a marginal model and linear mixed models. Cerebral oximetry was related to delirium diagnosis (P ≤ .0001) and severity (P ≤ .0001).

Conclusion

This study highlighted the links between increased cerebral oximetry values and delirium resorption. Oximetry values may be useful in monitoring delirium progression, thus assisting in the management of this complicated condition.