The Relationship Between Optic Nerve Sheath Diameter and Postoperative Delirium in Open Heart Surgery
Study Details
Study Description
Brief Summary
Although the incidence of delirium after cardiac surgery is high, it is not sufficiently recognized. The long-term effects of delirium are likely to be underestimated. In this study, the investigators aimed to examine the relationship between optic nerve sheath diameter and postoperative delirium in open hearth surgery.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
Postoperative delirium is characterized by widespread brain involvement and its incidence is between 6% and 30%. It appears twice as often after cardiac and vascular surgery than other types of surgery. The correlation between optic nerve sheath diameter (ONSD) and invasive intracranial pressure measurement is excellent. ONSD reduction has the potential to indicate intracranial hypoperfusion causing delirium. In this observational study, patients aged 18 years and over who will undergo open heart surgery will be examined. ONSD will be measured using ultrasound five times in the perioperative period (t0: pre-induction, t1: post-induction, t2: onset of cardiopulmonary bypass (CPB), t3: post-CPB, and t4: post-ICU admission). The Confusion Assessment Method for the ICU (CAM-ICU) test will be used to examine delirium in the ICU. Whether the change in ONSD is an independent risk factor for delirium will be evaluated.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| CAM-ICU positive delirium positive |
Diagnostic Test: ONSD
ultrasound measurement of the optic nerve sheath diameter
|
| CAM-ICU negative delirium negative |
Diagnostic Test: ONSD
ultrasound measurement of the optic nerve sheath diameter
|
Outcome Measures
Primary Outcome Measures
- The relationship between ONSD and postoperative delirium in cardiac surgery [6 months]
Peroperatively measured ONSD will be compared with the development of postoperative delirium.
- Incidence of delirium after open heart surgery [6 months]
Using the CAM-ICU test for delirium definition
Eligibility Criteria
Criteria
Inclusion Criteria:
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≥18 year old
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Elective open heart surgery
Exclusion Criteria:
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psychiatric illness
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neurological disease
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ophthalmic disease
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previous eye surgery
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perioperative cerebrovascular disease
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need for postoperative intraaortic balloon or extracorporeal support system
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Aynur Kaynar | Samsun | Turkey | 55270 |
Sponsors and Collaborators
- Samsun University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- Heyer EJ, DeLaPaz R, Halazun HJ, Rampersad A, Sciacca R, Zurica J, Benvenisty AI, Quest DO, Todd GJ, Lavine S, Solomon RA, Connolly ES Jr. Neuropsychological dysfunction in the absence of structural evidence for cerebral ischemia after uncomplicated carotid endarterectomy. Neurosurgery. 2006 Mar;58(3):474-80; discussion 474-80. doi: 10.1227/01.NEU.0000197123.09972.EA.
- Sekhon MS, Griesdale DE, Robba C, McGlashan N, Needham E, Walland K, Shook AC, Smielewski P, Czosnyka M, Gupta AK, Menon DK. Optic nerve sheath diameter on computed tomography is correlated with simultaneously measured intracranial pressure in patients with severe traumatic brain injury. Intensive Care Med. 2014 Sep;40(9):1267-74. doi: 10.1007/s00134-014-3392-7. Epub 2014 Jul 18. Erratum In: Intensive Care Med. 2015 Jan;41(1):177. Intensive Care Med. 2015 Jan;41(1):177.
- Smith W, Whitlock EL. Cardiac surgery, ICU sedation, and delirium: is dexmedetomidine the silver bullet? Curr Opin Anaesthesiol. 2023 Feb 1;36(1):50-56. doi: 10.1097/ACO.0000000000001207. Epub 2022 Nov 7.
- Zhang X, Medow JE, Iskandar BJ, Wang F, Shokoueinejad M, Koueik J, Webster JG. Invasive and noninvasive means of measuring intracranial pressure: a review. Physiol Meas. 2017 Jul 24;38(8):R143-R182. doi: 10.1088/1361-6579/aa7256.
- SÜKAEK-2023 11/7