The Relationship Between Optic Nerve Sheath Diameter and Postoperative Delirium in Open Heart Surgery

Study Overview
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Brief Summary
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Although the incidence of delirium after cardiac surgery is high, it is not sufficiently recognized. The long-term effects of delirium are likely to be underestimated. In this study, the investigators aimed to examine the relationship between optic nerve sheath diameter and postoperative delirium in open hearth surgery.

Detailed Description
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Postoperative delirium is characterized by widespread brain involvement and its incidence is between 6% and 30%. It appears twice as often after cardiac and vascular surgery than other types of surgery. The correlation between optic nerve sheath diameter (ONSD) and invasive intracranial pressure measurement is excellent. ONSD reduction has the potential to indicate intracranial hypoperfusion causing delirium. In this observational study, patients aged 18 years and over who will undergo open heart surgery will be examined. ONSD will be measured using ultrasound five times in the perioperative period (t0: pre-induction, t1: post-induction, t2: onset of cardiopulmonary bypass (CPB), t3: post-CPB, and t4: post-ICU admission). The Confusion Assessment Method for the ICU (CAM-ICU) test will be used to examine delirium in the ICU. Whether the change in ONSD is an independent risk factor for delirium will be evaluated.

Official Title
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The Relationship Between Optic Nerve Sheath Diameter and Postoperative Delirium in Open Heart Surgery

Conditions
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Delirium, Postoperative, Cardiac Disease, Cardiac Valve Disease

Intervention / Treatment
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* Diagnostic Test: ONSD


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥18 year old Elective open heart surgery Exclusion Criteria: psychiatric illness neurological disease ophthalmic disease previous eye surgery perioperative cerebrovascular disease need for postoperative intraaortic balloon or extracorporeal support system

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| CAM-ICU positive<br>delirium positive | Diagnostic Test: ONSD<br>* ultrasound measurement of the optic nerve sheath diameter<br>|
| CAM-ICU negative<br>delirium negative | Diagnostic Test: ONSD<br>* ultrasound measurement of the optic nerve sheath diameter<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The relationship between ONSD and postoperative delirium in cardiac surgery | Peroperatively measured ONSD will be compared with the development of postoperative delirium. | 6 months | 
| Incidence of delirium after open heart surgery | Using the CAM-ICU test for delirium definition | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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optic nerve sheath diameter, cardiac surgery, ultrasound