Preoperative biomarkers associated with delayed neurocognitive recovery

IF 2 3区 医学 Q2 ANESTHESIOLOGY
Mariana Thedim, Duygu Aydin, Gerhard Schneider, Rajesh Kumar, Matthias Kreuzer, Susana Vacas
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Abstract

To identify baseline biomarkers of delayed neurocognitive recovery (dNCR) using monitors commonly used in anesthesia. In this sub-study of observational prospective cohorts, we evaluated adult patients submitted to general anesthesia in a tertiary academic center in the United States. Electroencephalographic (EEG) features and cerebral oximetry were assessed in the perioperative period. The primary outcome was dNCR, defined as a decrease of 2 scores in the global Montreal Cognitive Assessment (MoCA) between the baseline and postoperative period. Forty-six adults (median [IQR] age, 65 [15]; 57% females; 65% American Society of Anesthesiologists (ASA) 3 were analyzed. Thirty-one patients developed dNCR (67%). Baseline higher EEG power in the lower alpha band (AUC = 0.73 (95% CI 0.48–0.93)) and lower alpha peak frequency (AUC = 0.83 (95% CI 0.48–1)), as well as lower cerebral oximetry (68 [5] vs 72 [3], p = 0.011) were associated with dNCR. Higher EEG power in the lower alpha band, lower alpha peak frequency, and lower cerebral oximetry values can be surrogates of baseline brain vulnerability.

Graphical abstract

Abstract Image

与神经认知功能延迟恢复相关的术前生物标志物
摘要利用麻醉中常用的监护仪确定延迟神经认知恢复(dNCR)的基线生物标志物。在这项观察性前瞻性队列子研究中,我们对在美国一家三级学术中心接受全身麻醉的成年患者进行了评估。在围手术期对脑电图(EEG)特征和脑氧饱和度进行了评估。主要结果是 dNCR,其定义是在基线和术后期间蒙特利尔认知评估(MoCA)的总体得分减少 2 分。对 46 名成人(中位数[IQR]年龄,65 [15];57% 女性;65% 美国麻醉医师协会 (ASA) 3 级)进行了分析。31 名患者出现了 dNCR(67%)。基线α低频段较高的脑电图功率(AUC = 0.73 (95% CI 0.48-0.93))和较低的α峰值频率(AUC = 0.83 (95% CI 0.48-1))以及较低的脑氧饱和度(68 [5] vs 72 [3],p = 0.011)与 dNCR 相关。低α波段较高的脑电图功率、较低的α峰值频率和较低的脑氧饱和度值可作为大脑基线脆弱性的替代指标。
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来源期刊
CiteScore
4.30
自引率
13.60%
发文量
144
审稿时长
6-12 weeks
期刊介绍: The Journal of Clinical Monitoring and Computing is a clinical journal publishing papers related to technology in the fields of anaesthesia, intensive care medicine, emergency medicine, and peri-operative medicine. The journal has links with numerous specialist societies, including editorial board representatives from the European Society for Computing and Technology in Anaesthesia and Intensive Care (ESCTAIC), the Society for Technology in Anesthesia (STA), the Society for Complex Acute Illness (SCAI) and the NAVAt (NAVigating towards your Anaestheisa Targets) group. The journal publishes original papers, narrative and systematic reviews, technological notes, letters to the editor, editorial or commentary papers, and policy statements or guidelines from national or international societies. The journal encourages debate on published papers and technology, including letters commenting on previous publications or technological concerns. The journal occasionally publishes special issues with technological or clinical themes, or reports and abstracts from scientificmeetings. Special issues proposals should be sent to the Editor-in-Chief. Specific details of types of papers, and the clinical and technological content of papers considered within scope can be found in instructions for authors.
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