Correlation of Electroencephalogram With Postoperative Delirium During Cardiac Surgery

Study Overview
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Brief Summary
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The purpose of this study is to explore characteristic changes of EEG epileptiform discharges in patients under CPB and correlation with POD

Detailed Description
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Cardiac surgery under cardiopulmonary bypass (CPB) as a result of the surgery itself great trauma and CPB this special process can lead to cerebral hypoperfusion, cerebral ischemia, increased in patients with postoperative neurological complications, the incidence of postoperative cognitive dysfunction can up to 44-53%.Postoperative delirium (POD) is not only increase the incidence of postoperative cognitive dysfunction forward, affect the quality of postoperative recovery and increased hospital costs, also associated with postoperative mortality. Although the clinical use of different drugs and technology improve the POD, but due to the mechanism is still unclear, is still lack of effective control measures. Electroencephalogram (EEG) can measure the cerebral cortex and subcortical local potential activities, to reflect the activities of the neurons in the brain. CPB can cause the abnormal vibration of brain waves, epileptiform discharges is the result of abnormal discharge of brain neurons, which is correlated with the occurrence of cognitive dysfunction.But whether EEG epileptiform discharges is related to the POD is uncertain.While epileptic seizures can be treated with anticonvulsant drugs, so the detection and treatment of early epileptic seizures may have important clinical significance for the occurrence of POD. Therefore, the main purpose of this study is to explore characteristic changes of EEG epileptiform discharges in patients under CPB and correlation with POD, offer the theoretical foundation for delirium early warning and prevention.

Official Title
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Correlation of Electroencephalogram Epileptiform Discharges With Postoperative Delirium During Cardiac Surgery

Conditions
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Electroencephalogram, Postoperative Delirium

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA II-III; No cognitive impairment was assessed one day before surgery; Patients undergoing elective CPB cardiac surgery(valvular heart surgery and coronary bypass surgery) and signed informed consent. Exclusion Criteria: Non-CPB surgery, macrovascular surgery, heart transplantation, correction of congenital heart disease; Stroke, schizophrenia, depression, Parkinson's disease, epilepsy or dementia; Inability to communicate with language impairment or major hearing or visual impairment; Liver function child-pugh Grade C, severe liver dysfunction; Severe renal insufficiency requires preoperative renal replacement therapy; A past history of intraoperative knowledge.
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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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of delirium after cardiac surgery | Postoperative evaluation delirium occurrence use the The Confusion Assessment Method(CAM) or The Confusion Assessment Method-intensive care unit(CAM-ICU). | The first day after surgery | 
| Incidence of delirium after cardiac surgery | Postoperative evaluation delirium occurrence use the CAM or CAM-ICU. | The second day after surgery | 
| Incidence of delirium after cardiac surgery | Postoperative evaluation delirium occurrence use the CAM or CAM-ICU. | The third day after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Epileptic discharge in electroencephalogram during cardiac surgery | The electroencephalogram (EEG) was collected by Masimo instrument, and the EEG was recognized by the neuroelectrophysiologist | Awake state after entering the operating room (baseline) | 
| Epileptic discharge in electroencephalogram during cardiac surgery | The electroencephalogram (EEG) was collected by Masimo instrument, and the EEG was recognized by the neuroelectrophysiologist | Start induction of anesthesia until leave the operating room | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Electroencephalogram, Epileptiform discharges, Postoperative delirium, Cardiac surgery