Cerebral Oxygen Consumption Response to Increased Oxygen Supply and Postoperative Delirium in Older Surgical Patients
Association Between Cerebral Oxygen Consumption Responsiveness to Increased Oxygen Supply and Postoperative Delirium: A Prospective Observational Study Using Functional Near-Infrared Spectroscopy
The goal of this observational study is to learn whether the brain's ability to use oxygen during surgery is associated with postoperative delirium in adults aged 65 years and older undergoing general anesthesia.
The main question it aims to answer is:
- Does reduced cerebral oxygen consumption responsiveness during surgery increase the risk of postoperative delirium in older patients?
Participants who are undergoing elective laparoscopic surgery under general anesthesia as part of their routine medical care will have brain oxygen levels measured during surgery using a non-invasive forehead sensor, and will be assessed for delirium for up to three days after surgery.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Soowon Lee, MD, PhD
- Phone Number: +82-31-787-7499
- Email: soowonlee@snubh.org
Study Locations
-
-
Gyeonggi-do
-
Seongnam-si, Gyeonggi-do, South Korea, 13620
- Recruiting
- Seoul National University Bundang Hospital
-
Contact:
- Soowon Lee, MD, PhD
- Phone Number: +82-31-787-7499
- Email: soowonlee@snubh.org
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients undergoing elective laparoscopic surgery under general anesthesia
- Age 65 years or older
Exclusion Criteria:
- Diagnosis of dementia or presence of delirium before surgery
- Loss of capacity to provide informed consent
- Moderate or severe cerebrovascular stenosis diagnosed before surgery
- Moderate or severe obstructive or restrictive pulmonary dysfunction identified on preoperative pulmonary function testing
- Requirement for supplemental oxygen therapy before surgery
- History of neurological disorders (e.g., Parkinson's disease, stroke) or prior brain surgery
- Severe hepatic dysfunction (AST or ALT > 120 IU/L)
- Severe renal dysfunction (estimated GFR < 15 mL/min/1.73 m²)
- Persistent severe hemodynamic instability (mean arterial pressure < 60 mmHg)
- Skin conditions preventing placement of the forehead fNIRS sensor
- Combined surgical procedures performed concurrently
- Planned postoperative admission to the intensive care unit
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Older patients undergoing elective laparoscopic surgery
Adults aged 65 years and older undergoing elective laparoscopic surgery under general anesthesia will be prospectively observed.
During surgery, cerebral oxygen levels will be measured using a non-invasive forehead sensor to assess the brain's oxygen utilization response within the range of routine anesthesia care.
Participants will be followed for up to three days after surgery to evaluate the occurrence of postoperative delirium.
|
Cerebral oxygenation will be monitored intraoperatively using a non-invasive forehead sensor based on functional near-infrared spectroscopy technology.
During general anesthesia, the fraction of inspired oxygen (FiO₂) may be temporarily adjusted within the standard clinical range used in routine anesthesia care to evaluate the brain's oxygen utilization response.
No experimental oxygen levels or additional therapeutic interventions will be administered beyond standard clinical practice.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Postoperative Delirium
Time Frame: Up to 3 days after surgery
|
Postoperative delirium diagnosed using 3D-CAM conducted in the post-anesthesia care unit and hospital ward.
Delirium will be defined as at least one positive assessment during the first three postoperative days.
|
Up to 3 days after surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Intraoperative Cerebral Oxygen Utilization Response (ΔHbO-HbR)
Time Frame: During surgery
|
Change in the difference between oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HbR), calculated as Δ(HbO-HbR), measured intraoperatively using functional near-infrared spectroscopy during variations in inspired oxygen concentration within the clinically applied range.
|
During surgery
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Predictive Performance of ΔHbO-HbR for Postoperative Delirium
Time Frame: Up to 3 days after surgery
|
Predictive accuracy of intraoperative Δ(HbO-HbR) for postoperative delirium assessed using receiver operating characteristic (ROC) curve analysis.
The area under the ROC curve (AUC) will be calculated to quantify discrimination.
|
Up to 3 days after surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- B-2602-1024-002
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Cerebral Oxygenation
-
NCT07517146Not yet recruitingıntraoperative Cerebral Oxygenation | Cerebral Oxygenation Monitoring
-
NCT01255618UnknownCerebral Oxygenation | Peripheric Oxygenation | Polycythaemic Infants
-
NCT04038398UnknownCerebral Oxygenation
-
NCT01496027Completed
-
NCT02806492CompletedCardiopulmonary Bypass | Cerebral Perfusion | Cerebral Oxygenation
-
NCT07477093CompletedCesarean Section | Neonatal Cerebral Oxygenation
-
NCT06886698Not yet recruitingBlood Pressure | Blood Flow | Cerebral Oxygenation
-
NCT05158881CompletedCerebral Oxygenation in Full-term Neonates
-
NCT03062306CompletedProviding Sufficient Cerebral Oxygenation During CPR
Clinical Trials on Intraoperative Cerebral Oxygen Utilization Assessment
-
NCT02071550Completed
-
NCT06929819Not yet recruitingGlioblastoma | Brain Tumor, Primary | Brain Tumor - Metastatic
-
NCT05198635RecruitingPostoperative Delirium | Carotid Endarterectomy | Cerebral Oxygen Saturation
-
NCT03165539UnknownDelirium | Thoracic Surgery
-
NCT07526077Enrolling by invitationAirway Reactivity | Hemodynamic Stability During Anesthesia
-
NCT06390280CompletedPostoperative Nausea and Vomiting | Laparoscopic Cholecystectomy
-
NCT05028855RecruitingCerebrovascular Stroke | Cerebral Artery Stenosis
-
NCT01673841CompletedElective Off-pump Coronary Artery Bypass Grafting