Brain Excitability, Cardiac Surgery, Postoperative Delirium
Conditions
Keywords
Brain excitability, Postoperative Delirium, Abnormal EEG, Excitatory amino acid, Heart valve replacement surgery
Brief summary
The purpose of this study is to explorethe brain excitability in patients undergoing heart valve replacement surgery with cardiopulmonary bypass and the correlation with postoperative delirium
Detailed description
Delirium is the most common surgical patients postoperative complications of brain dysfunction. Delirium is a kind of consciousness attention and cognitive function changes of acute brain dysfunction, with volatility and reversibility of postoperative delirium (POD), increased hospital costs and length of hospital stay and mortality rate, and can lower the quality of life, lead to long-term postoperative cognitive dysfunction and dementia. The incidence of postoperative cognitive dysfunction in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB) can be as high as 44-53%. However, since the specific mechanism of POD is still not clear, there is still a lack of effective prevention and treatment measures. Therefore, early detection and identification are helpful for the early treatment of POD.When brain injury occurs, the levels of excitatory neurotransmitters (glutamate and aspartate) will rise in a short period of time, and the high concentration of glutamate causes excessive intracellular calcium flow, causing cellular calcium overload, and generating excitatory cytotoxic effects. And abnormal electroencephalogram (EEG) is a kind of due to brain excitability/inhibitory amino acid imbalance caused by brain excitability increased result in abnormal discharge mode, can affect cognitive awareness and activities. Increased brain excitability is harmful to the potential, should avoid to happen. At present, the relationship between brain excitability and POD is still in exploring. Therefore, it is important to clarify the correlation between brain excitability and POD in patients undergoing cardiac valve replacement under CPB for improving the pathogenesis of POD.
Interventions
None listed
Sponsors
General Hospital of Ningxia Medical University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. ASA Ⅱ - Ⅲ; 2. No cognitive impairment was assessed one day before surgery; 3. Patients undergoing elective heart valve replacement under CPB and signed informed consent.
Exclusion criteria
1. Non-CPB surgery, macrovascular surgery, heart transplantation, correction of congenital heart disease; 2. Stroke, schizophrenia, depression, Parkinson's disease, epilepsy or dementia; 3. Inability to communicate with language impairment or major hearing or visual impairment; 4. Liver function child-pugh Grade C, severe liver dysfunction; 5. Severe renal insufficiency requires preoperative renal replacement therapy; 6. A past history of intraoperative knowledge.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The incidence of delirium after cardiac surgery | The first day after surgery | Postoperative evaluation delirium occurrence use the The Confusion Assessment Method(CAM) or The Confusion Assessment Method-intensive care unit(CAM-ICU). |
| Abnormal EEG during surgery | Complete EEG information from entry to exit of the operating room | The EEG was collected by Masimo instrument, and the EEG was recognized by the neuroelectrophysiologist, to identify whether the EEG of the patient was epileptic discharge and burst suppression during anesthesia |
| Plasma excitatory amino acid levels | Before the operation after entering the operating room (baseline) | Venous blood 5ml was collected and centrifuged (3500r/min,10min)，sera were separated and put into -80 deep temperature refrigerator for testing plasma excitatory amino acid levels. |
Countries
China
Contacts
Primary ContactXinli Ni, doctor
Backup ContactNa Li, doctor
Outcome results
None listed