Protocol for the Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography (P-DROWS-E) study: a prospective observational study of delirium in elderly cardiac surgical patients.

Autor:	Smith SK; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Nguyen T; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Labonte AK; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Kafashan M; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Hyche O; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Guay CS; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Wilson E; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Chan CW; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Luong A; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Hickman LB; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Fritz BA; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Emmert D; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Graetz TJ; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Melby SJ; Department of Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Lucey BP; Department of Neurology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Ju YS; Department of Neurology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Wildes TS; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Avidan MS; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA., Palanca BJA; Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, USA palancab@wustl.edu.; Department of Biomedical Engineering, Washington University in St Louis, Saint Louis, Missouri, USA.; Division of Biology and Biomedical Sciences, Washington University in St Louis, Saint Louis, Missouri, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2020 Dec 13; Vol. 10 (12), pp. e044295. Date of Electronic Publication: 2020 Dec 13.
DOI:	10.1136/bmjopen-2020-044295
Abstrakt:	Introduction: Delirium is a potentially preventable disorder characterised by acute disturbances in attention and cognition with fluctuating severity. Postoperative delirium is associated with prolonged intensive care unit and hospital stay, cognitive decline and mortality. The development of biomarkers for tracking delirium could potentially aid in the early detection, mitigation and assessment of response to interventions. Because sleep disruption has been posited as a contributor to the development of this syndrome, expression of abnormal electroencephalography (EEG) patterns during sleep and wakefulness may be informative. Here we hypothesise that abnormal EEG patterns of sleep and wakefulness may serve as predictive and diagnostic markers for postoperative delirium. Such abnormal EEG patterns would mechanistically link disrupted thalamocortical connectivity to this important clinical syndrome. Methods and Analysis: P-DROWS-E (Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography) is a 220-patient prospective observational study. Patient eligibility criteria include those who are English-speaking, age 60 years or older and undergoing elective cardiac surgery requiring cardiopulmonary bypass. EEG acquisition will occur 1-2 nights preoperatively, intraoperatively, and up to 7 days postoperatively. Concurrent with EEG recordings, two times per day postoperative Confusion Assessment Method (CAM) evaluations will quantify the presence and severity of delirium. EEG slow wave activity, sleep spindle density and peak frequency of the posterior dominant rhythm will be quantified. Linear mixed-effects models will be used to evaluate the relationships between delirium severity/duration and EEG measures as a function of time. Ethics and Dissemination: P-DROWS-E is approved by the ethics board at Washington University in St. Louis. Recruitment began in October 2018. Dissemination plans include presentations at scientific conferences, scientific publications and mass media. Trial Registration Number: NCT03291626. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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