Protocol for the Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography (P-DROWS-E) study: a prospective observational study of delirium in elderly cardiac surgical patients.
Protocol for the Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography (P-DROWS-E) study: a prospective observational study of delirium in elderly cardiac surgical patients.
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DOI：
10.1136/bmjopen-2020-044295
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发表时间：
2020-12-13
期刊：
影响因子：
2.9
通讯作者：
Palanca BJA
中科院分区：
文献类型：
--
作者：
Smith SK;Nguyen T;Labonte AK;Kafashan M;Hyche O;Guay CS;Wilson E;Chan CW;Luong A;Hickman LB;Fritz BA;Emmert D;Graetz TJ;Melby SJ;Lucey BP;Ju YS;Wildes TS;Avidan MS;Palanca BJA
谵妄是一种潜在的可预防的疾病，其特征是注意力和认知的急性障碍，严重程度波动。术后谵妄与重症监护室和住院时间延长、认知能力下降和死亡率相关。开发用于追踪谵妄的生物标志物可能有助于早期检测、缓解和评估对干预措施的反应。由于睡眠中断已被假定为这种综合征的发展的贡献者，在睡眠和觉醒期间异常脑电图（EEG）模式的表达可能是有益的。在这里，我们假设睡眠和觉醒的异常脑电图模式可以作为术后谵妄的预测和诊断标志。这种异常的脑电图模式将机制性地将丘脑皮层连接中断与这种重要的临床综合征联系起来。P-DROWS-E（使用觉醒和睡眠脑电图预测谵妄恢复结局）是一项220例患者的前瞻性观察性研究。患者资格标准包括那些讲英语，年龄60岁或以上，并接受择期心脏手术需要心肺转流。EEG采集将在术前1-2晚、术中和术后7天内进行。与EEG记录同时，每天两次术后意识模糊评估方法（CAM）评价将量化谵妄的存在和严重程度。将量化EEG慢波活动、睡眠纺锤体密度和后优势节律的峰值频率。将使用线性混合效应模型评价谵妄严重程度/持续时间与作为时间函数的EEG测量值之间的关系。P-DROWS-E是由圣路易斯华盛顿大学伦理委员会批准的。招聘于2018年10月开始。传播计划包括在科学会议、科学出版物和大众媒体上介绍情况。NCT 03291626。
Delirium is a potentially preventable disorder characterised by acute disturbances in attention and cognition with fluctuating severity. Postoperative delirium is associated with prolonged intensive care unit and hospital stay, cognitive decline and mortality. The development of biomarkers for tracking delirium could potentially aid in the early detection, mitigation and assessment of response to interventions. Because sleep disruption has been posited as a contributor to the development of this syndrome, expression of abnormal electroencephalography (EEG) patterns during sleep and wakefulness may be informative. Here we hypothesise that abnormal EEG patterns of sleep and wakefulness may serve as predictive and diagnostic markers for postoperative delirium. Such abnormal EEG patterns would mechanistically link disrupted thalamocortical connectivity to this important clinical syndrome. P-DROWS-E (Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography) is a 220-patient prospective observational study. Patient eligibility criteria include those who are English-speaking, age 60 years or older and undergoing elective cardiac surgery requiring cardiopulmonary bypass. EEG acquisition will occur 1–2 nights preoperatively, intraoperatively, and up to 7 days postoperatively. Concurrent with EEG recordings, two times per day postoperative Confusion Assessment Method (CAM) evaluations will quantify the presence and severity of delirium. EEG slow wave activity, sleep spindle density and peak frequency of the posterior dominant rhythm will be quantified. Linear mixed-effects models will be used to evaluate the relationships between delirium severity/duration and EEG measures as a function of time. P-DROWS-E is approved by the ethics board at Washington University in St. Louis. Recruitment began in October 2018. Dissemination plans include presentations at scientific conferences, scientific publications and mass media. NCT03291626.
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DOI：
10.2174/1874306401105010031
发表时间：
2011
期刊：
The open respiratory medicine journal
影响因子：
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作者：
Aldabal L;Bahammam AS
通讯作者：
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影响因子：
4
作者：
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影响因子：
3.7
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通讯作者：
Groupe d'Explorations Neurologiques en Réanimation (GENER)
DOI：
10.1097/aco.0000000000000061
发表时间：
2014-04
期刊：
Current opinion in anaesthesiology
影响因子：
--
作者：
Brown CH
通讯作者：
Brown CH
影响因子：
8.8
作者：
Al-Qadheeb NS;Skrobik Y;Schumaker G;Pacheco MN;Roberts RJ;Ruthazer RR;Devlin JW
通讯作者：
Devlin JW