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Surgery
Protocol
Road to recovery: a study protocol quantifying neurological outcome in cardiac surgery patients and the role of cerebral oximetry
  1. Joanna S Semrau1,
  2. Stephen H Scott1,2,
  3. Andrew G Hamilton3,4,
  4. Dimitri Petsikas3,4,
  5. Darrin M Payne3,4,
  6. Gianluigi Bisleri3,4,
  7. Tarit Saha5,6,
  8. John Gordon Boyd7
  1. 1 Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
  2. 2 Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
  3. 3 Cardiac Surgery, Kingston General Hospital, Kingston, Ontario, Canada
  4. 4 Surgery, Queen's University, Kingston, Ontario, Canada
  5. 5 Anesthesiology and Perioperative Medicine, Kingston General Hospital, Kingston, Ontario, Canada
  6. 6 Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada
  7. 7 Critical Care Medicine, Kingston General Hospital, Kingston, Ontario, Canada
  1. Correspondence to Dr John Gordon Boyd; gordon.boyd{at}kingstonhsc.ca

Abstract

Introduction Patients undergoing cardiac surgery may experience both short-term and long-term postoperative neurological problems. However, the underlying cause of this impairment is unclear. Regional cerebral oxygen saturation (rSO2) levels may play a role in the development of acute dysfunction, known as postoperative delirium, in addition to longer term outcomes after cardiac surgery. Yet the degree of impairment has been difficult to define, partly due to subjective methods of assessments. This study aims to fill this knowledge gap by determining the relationship between rSO2, postoperative delirium and long-term neurological outcome after cardiac surgery using quantitative robotic technology.

Methods and analysis 95 patients scheduled for elective cardiac surgery will be recruited for this single-centre prospective observational study. Patients will be assessed before as well as 3 and 12 months after their surgery using the Kinarm End-Point Lab and standardised tasks. Intraoperatively, rSO2 and other haemodynamic data will be collected for the duration of the procedure. Following their operation, patients will also be screened daily for delirium during their hospital stay.

Ethics and dissemination This study has been approved by the Health Sciences Research Ethics Board at Queen’s University (DMED-1672–14). The results of this study will be published in a peer-review journal and presented at international and/or national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.

Trial registration number NCT04081649

  • post-operative cognitive dysfunction
  • cardiac surgery
  • delirium
  • robotic technology
  • neurological assessment

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-032935

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    Footnotes

    • Twitter @jssemrau

    • Contributors JSS prepared the manuscript, designed the statistical plan and performed sample size calculations. AGH, DP, DMP, GB, TS and SHS constructively contributed to the manuscript and the protocol plan. JGB conceptualised the project and is the acting supervisor of this study. All authors have read and approved this manuscript prior to submission.

    • Funding This work was supported by the Southeastern Ontario Academic Medical Organization (SEAMO) Innovation fund.

    • Competing interests JSS, AGH, DMP, DP, GB and TS have no competing interests. SHS is the inventor of the KINARM robot and co-founder of BKIN technologies. JGB receives a stipend from the Trillium of Life Network for his role as a hospital donation physician.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.