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. 2011;3(1):47-58.

Impact of bispectral index monitoring on postoperative delirium in patients undergoing aortic surgery

G Santarpino  1 , R Fasol, J Sirch, B Ackermann, S Pfeiffer, T Fischlein
Affiliations

Impact of bispectral index monitoring on postoperative delirium in patients undergoing aortic surgery

G Santarpino et al. HSR Proc Intensive Care Cardiovasc Anesth. 2011.

Abstract

Background: Bispectral index monitoring can facilitate anesthesia care. We evaluated the association of Bispectral index with postoperative neurological outcome and delirium in patients undergoing aortic surgery.

Methods: From 2006 to 2009, 292 consecutive patients undergoing aortic surgery were retrospectively reviewed. Patients were classified into 5 groups according to Bispectral index reduction: Group I (≤15%), Group II (15-20%), Group III (20-25%), Group IV (25-30%), and Group V (>30%).

Results: The number of patients in each group was : 52 (17.8%), Group I; 125 (42.8%), Group II;68 (23.3%), Group III; 33 (11.3%), Group IV; 14 (4.8%), Group V. The incidence of delirium and neurological events was higher in Group IV and Group V(90.9% and 18.2% in Group IV, and 71% and 79% in Group V; both p<0.001). Only Group V showed a longer intensive care unit stay compared to Group I (13.5±10.3 vs 5.4±6.6 days; p=0.002), Group II (7.3±8.6 days, p=0.005) and Group III (6.7±6.5 days, p=0.015). Group V also showed a longer intubation time compared to Group I (228±211 vs 73±112 hours; p=0.008) and Group II (105±177 hours, p=0.002).

Conclusions: Our data suggest a higher incidence of neurological deficits in patients with a Bispectral index reduction of >25% from baseline. Explanations for these findings are speculative with regard to the underlying mechanisms, and larger studies are warranted to clarify these issues.

Keywords: aortic surgery; bispectral index monitoring; cerebral complications; delirium.

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Conflict of interest statement

Source of Support Nil.

Conflict of interest None declared.

Figures

Table 1
Table 1
AVR = aortic valve replacement; CABG = coronary artery bypass graft; CPB = cardiopulmonary bypass; ICU = intensive care unit; LVEF = left ventricular ejection fraction; NYHA = New York Heart Association; RIND = reversible ischemic neurological disease; TIA = transient ischemic attack. Clinical characteristics, intra- and post-operative parameters of the study population (292 patients).
Table 2
Table 2
Clinical characteristics, intra- and postoperative parameters of the study group
Figure 1
Figure 1
Incidence of delirium and neurological events in the study population (*p < 0.001)
Table 3
Table 3
Clinical characteristics, intra- and postoperative parameters of aortic dissection patients
Figure 2
Figure 2
Incidence of delirium and neurological events in aortic dissection patients. (*p < 0.001; §p = 0.002; #p = 0.003)
See this image and copyright information in PMC

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