Kaynar Aynur, Kömürcü Özgür, Bahşi Esma, Aydın Ahmet Ozan, Karal İlker Hasan, Akyurt Dilan, Tulgar Serkan, Süren Mustafa
Department of Anesthesiology and Reanimation, Samsun University Faculty of Medicine, İlkadım, TR55090, Samsun, Turkey.
Department of Cardiac and Vascular Surgery, Samsun University Faculty of Medicine, Samsun, Turkey.
BMC Anesthesiol. 2025 Jul 1;25(1):309. doi: 10.1186/s12871-025-03194-9.
Increased intracranial pressure is a possible cause of postoperative delirium in open heart surgery patients. Optic nerve sheath diameter is a non-invasive measurement method used to monitor intracranial pressure changes. The authors suggested in this study that optic nerve sheath diameter monitoring could identify patients at risk of postoperative delirium.
This prospective observational study was conducted by evaluating data from 90 patients undergoing open heart surgery. Optic nerve sheath diameter in patients was recorded before and after anesthesia induction, before and after cardiopulmonary bypass, and after intensive care transfer. Postoperative delirium was evaluated with the Confusion Assessment Method for the Intensive Care Unit scale.
The study was completed with 90 patients and postoperative delirium was observed in 20 of the patients (22.2%). Optic nerve sheath diameter (OR, 5.787; 95% CI, 1.489-22.496; P = 0.011), history of alcohol use (OR, 6.032; 95% CI, 1.052-34.604; P = 0.044), and EuroSCORE II (OR, 3.090; 95% CI, 1.453-6.571; P = 0.003) was associated with postoperative delirium.
Optic nerve sheath diameter measured by ultrasonography is associated with postoperative delirium. The increase in optic nerve sheath diameter can be used predictively for postoperative delirium in open heart surgery.
Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 2023 11/7) and Clinical Trials (NCT05942183 / 05.09.2024) registration.
颅内压升高是心脏直视手术患者术后谵妄的一个可能原因。视神经鞘直径是一种用于监测颅内压变化的非侵入性测量方法。作者在本研究中表明，视神经鞘直径监测可识别有术后谵妄风险的患者。
本前瞻性观察性研究通过评估90例接受心脏直视手术患者的数据进行。记录患者在麻醉诱导前、体外循环前后以及重症监护病房转运后的视神经鞘直径。采用重症监护病房意识模糊评估法量表评估术后谵妄。
90例患者完成研究，其中20例（22.2%）出现术后谵妄。视神经鞘直径（比值比，5.787；95%置信区间，1.489 - 22.496；P = 0.011）、饮酒史（比值比，6.032；95%置信区间，1.052 - 34.604；P = 0.044）和欧洲心脏手术风险评估系统II（比值比，3.090；95%置信区间，1.453 - 6.571；P = 0.003）与术后谵妄相关。
超声测量的视神经鞘直径与术后谵妄相关。视神经鞘直径的增加可用于预测心脏直视手术患者的术后谵妄。
萨姆松大学萨姆松培训与研究医院，经伦理委员会批准（萨姆松大学临床研究伦理委员会（KAEK）2023 11/7）并进行临床试验注册（NCT05942183 / 2024年9月5日）。
