Postoperative Delirium: EEG Markers of Sleep and Wakefulness
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 60 - Any |
| Updated: | 11/1/2018 |
| Start Date: | October 16, 2018 |
| End Date: | February 2022 |
| Contact: | Jacob Bolzenius, PhD |
| Email: | bolzeniusj@wustl.edu |
| Phone: | 314 747-8423 |
Postoperative delirium is a condition in which patients develop temporary difficulties in
maintaining attention and thinking clearly. These new problems can appear after surgery and
change throughout the day. This confusion can last several days.
The overall purpose of this study is to measure brain activity during sleep and wakefulness
to learn about their relationships to delirium after surgery. While participants may not feel
like their normal self during the study, they are in the best position to help us learn how
to improve the recovery of brain function and sleep in others having surgery. The
investigators need to learn from those who have and have not become confused after their
surgical procedure.
maintaining attention and thinking clearly. These new problems can appear after surgery and
change throughout the day. This confusion can last several days.
The overall purpose of this study is to measure brain activity during sleep and wakefulness
to learn about their relationships to delirium after surgery. While participants may not feel
like their normal self during the study, they are in the best position to help us learn how
to improve the recovery of brain function and sleep in others having surgery. The
investigators need to learn from those who have and have not become confused after their
surgical procedure.
Postoperative delirium is a condition that can develop in some older patients after they have
surgery and receive general anesthesia. Patients that develop delirium have difficulty
maintaining attention and thinking clearly. Both of these issues can come and go throughout
the day. The incidence of postoperative delirium is greater than 25% and is associated with
longer hospitalization and increased risk of persistent mental and physical decline. It is
thought that this disorder may be preventable, but there is no agreed upon way of identifying
which patients are at risk for delirium prior to their surgery. Additionally, patients with
atypical delirium are often misdiagnosed or undiagnosed postoperatively.
Based on previous research, the researchers have hypothesized that delirium may be directly
related to wakefulness and sleep problems, as shown on electroencephalography [EEG]. EEG is a
test that records the electrical activity of brain through placement of small wires on a
person's scalp. In light of this, the purpose of this study is to evaluate sleep and
wakefulness using EEG before, during and after surgery in order to discover any abnormalities
of sleep or wakefulness that associate with postoperative delirium onset, severity, and
length of recovery. Subjects in this study will have preoperative at home sleep testing
performed, using a device called the Sleep Profiler, and questionnaires administered to
characterize their mental function and brain function prior to surgery. When they arrive for
their scheduled surgery, the subjects will be fitted with the Sleep Profiler to record brain
activity during surgery and after surgery for 5 days. Postoperatively, the subjects will be
asked to do simple tasks like move toes and fingers and to answer questions that assess their
mental state.
surgery and receive general anesthesia. Patients that develop delirium have difficulty
maintaining attention and thinking clearly. Both of these issues can come and go throughout
the day. The incidence of postoperative delirium is greater than 25% and is associated with
longer hospitalization and increased risk of persistent mental and physical decline. It is
thought that this disorder may be preventable, but there is no agreed upon way of identifying
which patients are at risk for delirium prior to their surgery. Additionally, patients with
atypical delirium are often misdiagnosed or undiagnosed postoperatively.
Based on previous research, the researchers have hypothesized that delirium may be directly
related to wakefulness and sleep problems, as shown on electroencephalography [EEG]. EEG is a
test that records the electrical activity of brain through placement of small wires on a
person's scalp. In light of this, the purpose of this study is to evaluate sleep and
wakefulness using EEG before, during and after surgery in order to discover any abnormalities
of sleep or wakefulness that associate with postoperative delirium onset, severity, and
length of recovery. Subjects in this study will have preoperative at home sleep testing
performed, using a device called the Sleep Profiler, and questionnaires administered to
characterize their mental function and brain function prior to surgery. When they arrive for
their scheduled surgery, the subjects will be fitted with the Sleep Profiler to record brain
activity during surgery and after surgery for 5 days. Postoperatively, the subjects will be
asked to do simple tasks like move toes and fingers and to answer questions that assess their
mental state.
Inclusion Criteria:
1. English speaking
2. Age 60 or older
3. Scheduled for cardiac surgery requiring cardiopulmonary bypass for coronary artery
bypass grafting and/or heart valve repair/replacement
Exclusion Criteria:
1. Pre-existing delirium or dementia
2. Legal blindness or severe deafness
3. Surgery requiring deep hypothermic circulatory rest
We found this trial at
1
site
4940 Forest Park Avenue
Saint Louis, Missouri 63108
Saint Louis, Missouri 63108
Principal Investigator: Ben Palanca, MD, PhD, MSc
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