Cerebral Blood Flow During CPB During Cardiac Surgery and the Presence of Post op Delirium

Study Overview
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Brief Summary
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Cardiac surgery is associated with multiple events and issues that increase risk for adverse postoperative neurological outcomes including postoperative cognitive dysfunction. The risk for postoperative delirium is generally thought to result from some previous health factors added to the susceptibility of the cardiac surgery process.

Detailed Description
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Cardiac surgery is associated with multiple perturbations that increase risk for adverse postoperative neurological outcomes including postoperative cognitive dysfunction. These same perturbations likely also increase the risk for postoperative delirium although there are little data that have evaluated this hypothesis. As the subject is prepared for surgery 2 contact probes will be placed on the forehead to monitor the rSO2 and cerebral blood flow. This monitor can also measureblood flow velocity in blood vessels in the forehead. This will only be done while the subject is on the cardiac bypass machine during the surgery and end shortly after entering the intensive care unit.Prior to surgery and then once a day on three of the first four postoperative days, patients will be assessed for the presence and severity of delirium with brief standard psychological exams. We will compare rSO2 and CBF changes between patients with and without delirium

Official Title
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Non Invasive Monitoring of Cerebral Blood Flow During and After Cardiopulmonary Bypass to Assess and Compare for the Presence of Delirium in Post Operative Patients (DELIRIUM)

Conditions
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Delirium

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients in the study will be 50 or older undergoing elective cardiovascular surgery using cardiopulmonary bypass. Patients who can speak, read and understand the English language. Patients who understand the nature of the study and are willing to sign the consent form Exclusion Criteria: Emergency surgery or patients intubated before surgery and, thus, cannot give informed consent. Patients diagnosed with neurocognitive disorders (e.g. Alzheimer's, Dementia) MMSE score greater than 21 Patients taking antipsychotic drugs A history of drug abuse Patients with an implant in the brain underneath the CerOx probes Women who are pregnant. History of significant, prohibitive skin allergies or reactions-

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| no intervention<br>Contact with enrolled subjects requires application of ceberal oximetry electrodes and the concommittent ultrasound of the temporal artery. Deemed interventional by JHUIRB but no actual intervention done to subject. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To evaluate whether rSO2 and/or CBF during CPB is lower in patients who experience delirium within three days after cardiac surgery compared with patients without delirium | To evaluate whether rSO2 and/or CBF during CPB is lower in patients who experience delirium within three days after cardiac surgery compared with patients without delirium. | 3 days post op | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| recovery pattern of rSO2 | To evaluate the recovery pattern of rSO2 and CBF for up to 6 hrs after CPB for ICU patients who experience delirium within three days after cardiac surgery compared with patients without delirium. | 3 post op days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CBF autoregulation, rSO2,doppler, TCD, delirium,