Key result
Neuromonitoring modalities during cardiac surgery are used to predict neurocognitive dysfunction and guide interventions to optimize cerebral oxygen supply and reduce postoperative delirium.
Why the study?
Neurocognitive dysfunction after cardiac surgery carries a significant healthcare burden, yet there is no single, definitive neuromonitor.
Does neuromonitoring during cardiac surgery predict or reduce postoperative neurocognitive dysfunction?
Does neuromonitoring during cardiac surgery predict or reduce postoperative neurocognitive dysfunction?
Neuromonitoring during cardiac surgery involves multiple modalities to assess cerebral perfusion and function, which may help predict and mitigate postoperative neurocognitive complications.
May guide cerebral optimization to reduce postoperative delirium; leaves open the need for RCTs on optimal modalities and outcomes.
Neurocognitive dysfunction after cardiac surgery can present with diverse clinical phenotypes, which include postoperative delirium, postoperative cognitive dysfunction, and stroke, and it presents a significant healthcare burden for both patients and providers. Neurologic monitoring during cardiac surgery includes several modalities assessing cerebral perfusion and oxygenation (near-infrared spectroscopy, transcranial Doppler and jugular venous bulb saturation monitoring) and those that measure cerebral function (processed and unprocessed electroencephalogram), reflecting an absence of a single, definitive neuromonitor. This narrative review briefly describes the technologic basis of these neuromonitoring modalities, before exploring their use in clinical practice, both as tools to predict neurocognitive dysfunction, and with a bundle of interventions designed to optimize cerebral oxygen supply, with the aim of reducing postoperative delirium and cognitive dysfunction following cardiac surgery.
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Milne et al. (2021) conducted a review in Neurocognitive dysfunction after cardiac surgery. Neuromonitoring modalities was evaluated. Neuromonitoring modalities during cardiac surgery are used to predict neurocognitive dysfunction and guide interventions to optimize cerebral oxygen supply and reduce postoperative delirium.
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