Thedim Mariana, Aydin Duygu, Schneider Gerhard, Kumar Rajesh, Kreuzer Matthias, Vacas Susana
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street 444GRB, Boston, MA, 02114, USA.
Department of Anesthesiology and Intensive Care Medicine, Technical University of Munich School of Medicine, Munich, Germany.
J Clin Monit Comput. 2025 Feb;39(1):1-9. doi: 10.1007/s10877-024-01218-2. Epub 2024 Sep 12.
To identify baseline biomarkers of delayed neurocognitive recovery (dNCR) using monitors commonly used in anesthesia. In this sub-study of observational prospective cohorts, we evaluated adult patients submitted to general anesthesia in a tertiary academic center in the United States. Electroencephalographic (EEG) features and cerebral oximetry were assessed in the perioperative period. The primary outcome was dNCR, defined as a decrease of 2 scores in the global Montreal Cognitive Assessment (MoCA) between the baseline and postoperative period. Forty-six adults (median [IQR] age, 65 [15]; 57% females; 65% American Society of Anesthesiologists (ASA) 3 were analyzed. Thirty-one patients developed dNCR (67%). Baseline higher EEG power in the lower alpha band (AUC = 0.73 (95% CI 0.48-0.93)) and lower alpha peak frequency (AUC = 0.83 (95% CI 0.48-1)), as well as lower cerebral oximetry (68 [5] vs 72 [3], p = 0.011) were associated with dNCR. Higher EEG power in the lower alpha band, lower alpha peak frequency, and lower cerebral oximetry values can be surrogates of baseline brain vulnerability.
使用麻醉中常用的监测设备来识别延迟神经认知恢复（dNCR）的基线生物标志物。在这项观察性前瞻性队列的子研究中，我们评估了美国一家三级学术中心接受全身麻醉的成年患者。在围手术期评估脑电图（EEG）特征和脑氧饱和度。主要结局是dNCR，定义为基线期和术后期间蒙特利尔认知评估量表（MoCA）总分下降2分。分析了46名成年人（年龄中位数[四分位间距]为65[15]岁；57%为女性；65%为美国麻醉医师协会（ASA）3级）。31名患者出现dNCR（67%）。较低α频段的基线EEG功率较高（AUC = 0.73（95%CI 0.48 - 0.93））、α波峰值频率较低（AUC = 0.83（95%CI 0.48 - 1））以及较低的脑氧饱和度（68[5]对72[3]，p = 0.011）与dNCR相关。较低α频段的较高EEG功率、较低的α波峰值频率和较低的脑氧饱和度值可能是基线脑易损性的替代指标。
