Anticipating Postoperative Delirium During Burst Suppression Using Electroencephalography

Area of Science:

• Neuroscience
• Cardiology
• Critical Care Medicine

Background:

• Cardiac surgeries using deep hypothermia circulatory arrest (DHCA) carry risks of cerebral injury and postoperative delirium.
• Postoperative delirium is associated with poor patient outcomes and prolonged hospital stays.

Purpose of the Study:

• To develop an electroencephalography (EEG)-based method for early prediction of postoperative delirium.
• To assess the utility of monitoring burst suppression during DHCA for delirium prediction.

Main Methods:

• Formulated a burst suppression duty cycle (BSDC) metric to quantify electrophysiological activity during cooling and warming.
• Correlated the time of suppression activity cessation post-cardiopulmonary bypass with delirium diagnoses.

Main Results:

• The BSDC metric accurately predicted postoperative delirium in 15 out of 16 cases when compared against a benchmark.
• Similar prediction accuracy was achieved by monitoring BSDC progress earlier during the rewarming phase.

Conclusions:

• The developed BSDC metric shows promise for the early detection of postoperative delirium.
• This methodology may enable timely interventions to mitigate the incidence and impact of delirium after cardiac surgery.