Delirium, Cerebral Perfusion, and High-Frequency Vital-Sign Monitoring in the Critically Ill. The CONFOCAL-2 Feasibility Study

Khan, Jasmine; Wood, Michael D.; Lee, Kevin F. H.; Maslove, David; Muscedere, John; English, Shane; Ball, Ian; Slessarev, Marat; Hunt, Miranda; Boyd, J. Gordon

doi:10.1513/annalsats.202002-093oc

Cited by 8 publications

(8 citation statements)

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“…Continuous rSO2 data throughout each form of dialysis will be summarised using four variables, which together comprise the Cerebral Perfusion Index (CPI): (1) mean intradialytic rSO2, (2) delta-rSO2, (3) duration of disturbed cerebral autoregulation and (4) AUC outside of the optimal MAP. 67 These four summary variables have been used to describe cerebral oxygenation in previous reports. 67–69 …”

Section: Methods and Analysismentioning

confidence: 99%

“… 67 These four summary variables have been used to describe cerebral oxygenation in previous reports. 67–69 …”

Section: Methods and Analysismentioning

confidence: 99%

“… 31 Cumulative duration of disturbed cerebral autoregulation will be taken as the length of time during each recording session for which COx values were positive. 67 68 Duration of disturbed cerebral autoregulation will be taken as the percentage of total recording time during which cerebral autoregulation was disturbed (ie, the cumulative duration of cerebral autoregulation dysfunction will be divided by the total recording time and then multiplied by 100 to calculate the percentage of time with cerebral autoregulation dysfunction). 31 …”

Section: Methods and Analysismentioning

confidence: 99%

“…Optimal MAP±SD will be calculated as the mean MAP for COx of 0±1 SD. 67 AUC outside of the optimal MAP will be taken as the proportion of the AUC where AUC was outside of the range of the optimal MAP. 67 …”

Section: Methods and Analysismentioning

confidence: 99%

“… 67 AUC outside of the optimal MAP will be taken as the proportion of the AUC where AUC was outside of the range of the optimal MAP. 67 …”

Section: Methods and Analysismentioning

confidence: 99%

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Identifying neurocognitive outcomes and cerebral oxygenation in critically ill adults on acute kidney replacement therapy in the intensive care unit: the INCOGNITO-AKI study protocol

et al. 2021

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IntroductionInitiation of acute kidney replacement therapy (KRT) is common in critically ill adults admitted to the intensive care unit (ICU), and associated with increased morbidity and mortality. KRT has been linked to poor neurocognitive outcomes, leading to reduced quality of life and increased utilisation of healthcare resources. Adults on dialysis in the ICU may be particularly at risk of neurocognitive impairment, as survivors of critical illness are already predisposed to developing cerebrovascular disease and cognitive dysfunction long-term relative to healthy controls. Regional cerebral oxygen saturation may provide a critical early marker of long-term neurocognitive impairment in this population. This study aims to understand cerebral oxygenation in patients undergoing KRT (continuous or intermittent) in the ICU. These findings will be correlated with long-term cognitive and functional outcomes, and structural brain pathology.Methods and analysis108 patients scheduled to undergo treatment for acute kidney injury with KRT in the Kingston Health Sciences Centre ICU will be recruited into this prospective observational study. Enrolled patients will be assessed with intradialytic cerebral oximetry using near infrared spectroscopy. Delirium will be assessed daily with the Confusion Assessment Method-ICU (CAM-ICU) and severity quantified as cumulative CAM-ICU-7 scores. Neurocognitive impairment will be assessed at 3 and 12 months after hospital discharge using the Kinarm and Repeatable Battery for the Assessment of Neuropsychological Status. Structural brain pathology on MRI will also be measured at the same timepoints. Driving safety, adverse events and medication adherence will be assessed at 12 months to evaluate the impact of neurocognitive impairment on functional outcomes.Ethics and disseminationThis study is approved by the Queen’s University Health Sciences/Affiliated Teaching Hospitals Research Ethics Board (DMED-2424-20). Results will be presented at critical care conferences, and a lay summary will be provided to patients in their preferred format.Trial registration numberNCT04722939

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Section: Methods and Analysismentioning

confidence: 99%

“… 67 These four summary variables have been used to describe cerebral oxygenation in previous reports. 67–69 …”

Section: Methods and Analysismentioning

confidence: 99%