Cerebral oximetry as a biomarker of postoperative delirium in cardiac surgery patients.
A promising monitoring strategy for delirium is the use of cerebral oximetry, but its validity during delirium is unknown. We assessed the relationship between oximetry and delirium. We hypothesized that as cerebral oximetry values increased, delirium would resorb.



An observational study was conducted with 30 consecutive adults with delirium after cardiac surgery. Oximetry, delirium assessments, and clinical data were collected for 3 consecutive days after delirium onset. Oximetry was obtained using near-infrared spectroscopy. Delirium was assessed using diagnosis, occurrence (Confusion Assessment Method-ICU), and severity scales (Delirium Index).



All patients presented delirium at entry. The mean oximetry value decreased from 66.4±6.7 (mean±SD) to 50.8±6.8 on the first day after delirium onset and increased in patients whose delirium resorbed over the 3 days. The relationship between oximetry, delirium diagnosis, and severity was analyzed with a marginal model and linear mixed models. Cerebral oximetry was related to delirium diagnosis (P≤.0001) and severity (P≤.0001).



This study highlighted the links between increased cerebral oximetry values and delirium resorption. Oximetry values may be useful in monitoring delirium progression, thus assisting in the management of this complicated condition.
Montreal Heart Institute Research Center S-2490, Montreal, Quebec, Canada H1T 1C8; Faculty of Nursing, Universite de Montreal, Montreal, Quebec, Canada H3T 1A8. Electronic address: t.mailhot@umontreal.ca.
Tanya
T
Mailhot
Montreal Heart Institute Research Center S-2490, Montreal, Quebec, Canada H1T 1C8; Faculty of Nursing, Universite de Montreal, Montreal, Quebec, Canada H3T 1A8. Electronic address: sylvie.cossette.inf@umontreal.ca.
Sylvie
S
Cossette
Department of Social and Preventive Medicine, School of Public Health, Universite de Montreal, Montreal, Québec, Canada H3N 1X9; Montreal Health Innovations Coordinating Center, Montreal, Quebec, Canada H1Y 3N1. Electronic address: Jean.lambert@umontreal.ca.
Jean
J
Lambert
Faculty of Medicine, Universite de Montréal, Montreal, Quebec, Canada H3T 1J4. Electronic address: alexis.cournoyer@umontreal.ca.
Alexis
A
Cournoyer
Faculty of Medicine, Universite de Montréal, Montreal, Quebec, Canada H3T 1J4; Department of Anesthesiology, Montreal Heart Institute, Montreal, Quebec, Canada H1T 1C8. Electronic address: andre.denault@gmail.com.
André Y
AY
Denault
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015415:Biomarkers; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002560:Cerebrovascular Circulation / Q000502:physiology; D054022:Cerebrum / Q000098:blood supply / Q000378:metabolism; D003693:Delirium / Q000175:diagnosis; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D011183:Postoperative Complications / Q000175:diagnosis; D019265:Spectroscopy, Near-Infrared / Q000379:methods
D015415:Biomarkers; D010100:Oxygen
Cerebral oximetry; Delirium; Near-infrared; Postoperative complications; Spectroscopy; Thoracic surgery