Brain Tumor, Delirium
Conditions
Brief summary
Postoperative delirium is a common acute central nervous system syndrome, which often occurs 1-5 days after surgery. Postoperative delirium can prolong the length of hospital stay, increase the mortality rate, and is also associated with long-term postoperative cognitive dysfunction. However, the pathogenesis of postoperative delirium in elderly patients undergoing neurosurgical procedures, who are at high risk for ostoperative delirium, remains unclear. This study aims to elucidate the underlying mechanisms of postoperative delirium in this population and inform the development of effective prevention and treatment strategies.
Interventions
None listed
Sponsors
Beijing Tiantan Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients undergoing elective craniotomy for intracranial tumour resection * Patients who will provide written informed consent
Exclusion criteria
* Patients with severe preoperative cognitive impairment precluding subsequent assessments * History of psychotropic medication use * Previous history of neurosurgical operation * Severe bradycardia (heart rate \< 40 beats per minute) * Sick-sinus syndrome or atrioventricular block of grade Ⅱ or above * Severe hepatic insufficiency (Child-Pugh grade C) * Renal failure requiring renal replacement therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The association between intraoperative hypotension and postoperative delirium | The surgery day and twice a day (from 8:00 to 10:00 and from 18:00 to 20:00) during the first postoperative 5 days. | Intraoperative hypotension was defined by absolute mean arterial pressure (MAP) thresholds (sustained MAP \< 75, 70, 65, or 60 mm Hg for \> 1 min) or relative MAP reductions (10%, 20%, 30%, or 40% below preoperative baseline). The Confusion Assessment Method for the Intensive Care Unit scale (CAM-ICU) or 3 min diagnostic interview for CAM (3D-CAM) will be applied to assess postoperative delirium. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Characteristic of electroencephalogram | The surgery day | Electroencephalographic signals will be acquired with the Masimo SedLine® monitor, which will yield the Patient State Index (PSI), burst-suppression ratio, raw EEG traces, density spectral array, spectral edge frequency, and electromyographic data. Frequency bands will be predefined as delta (1-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), and beta (13-40 Hz). Relative power for each band will be computed relative to total spectral power. |
| Regional cerebral oxygen saturation changes | The surgery day | Regional cerebral oxygen saturation will be monitored with near-infrared spectroscopy. |
| Blood inflammatory factors | The surgery day | Arterial blood (4 mL) will be collected from patients during surgery, and blood inflammatory factors will be measured. |
Countries
China
Contacts
CONTACTYuming Peng, M.D., Ph.D
Outcome results
None listed