Evidence map›Paper›PMID 39446661›Full record

ArticleAnesthesia and analgesia2025

Incidence of Concurrent Cerebral Desaturation and Electroencephalographic Burst Suppression in Cardiac Surgery Patients.

Rushil Vladimir Ramachandran, Alkananda Behera, Zaid Hussain, Jordan Peck, Ajay Ananthakrishanan, Priyam Mathur, Valerie Banner-Goodspeed, J Danny Muehlschlegel, Jean-Francois Pittet, Amit Bardia and 4 more

Abstract read
In one paragraph

Article in Anesthesia and analgesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Rushil Vladimir RamachandranFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Alkananda BeheraBeth Israel Deaconess Medical Center, Boston, Massachusetts.
Zaid HussainFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Jordan PeckFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Ajay AnanthakrishananFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Priyam MathurFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Valerie Banner-GoodspeedFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
J Danny MuehlschlegelDepartment of Anesthesiology, Brigham and Women's Hospital, Boston, Massachusetts.
Jean-Francois PittetDepartment of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama.
Amit BardiaDepartment of Anesthesiology, Massachusetts General Hospital, Boston, Massachusetts.
Robert SchonbergerDepartment of Anesthesiology, Yale School of Medicine, New Haven, Connecticut.
Edward R MarcantonioDepartment of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Kestutis KveragaFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Balachundhar SubramaniamFrom the Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Funding

Scheduled Prophylactic 6-hourly IV Acetaminophen to Prevent Postoperative Delirium in Older Cardiac Surgical Patients (PANDORA) - EEG Administrative SupplementR01AG065554 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MARCANTONIO, EDWARD R, SUBRAMANIAM, BALACHUNDHAR · 2019 to 2025
$7.4M
NIA NIH HHS R01 AG065554NIH HHS 5R01AG065554
6 · The paper itself

Abstract

backgroundIncreased intraoperative electroencephalographic (EEG) burst suppression is associated with postoperative delirium. Cerebral desaturation is considered as one of the factors associated with burst suppression. Our study investigates the association between cerebral desaturation and burst suppression by analyzing their concurrence. Additionally, we aim to examine their association with cardiac surgical phases to identify potential for targeted interventions.

methodsWe retrospectively analyzed intraoperative 1-minute interval observations in 51 patients undergoing cardiac surgery. Processed EEG and cerebral oximetry were collected, with the anesthesiologists blinded to the information. The associations between cerebral desaturation (defined as a 10% decrease from baseline) and burst suppression, as well as with phase of cardiac surgery, were analyzed using the Generalized Logistic Mixed Effect Model. The results were presented as odds ratio and 95% confidence intervals (CIs). A value of P < .05 was considered statistically significant.

resultsThe odds of burst suppression increased 1.5 times with cerebral desaturation (odds ratio [OR], 1.52, 95% CI, 1.11-2.07; P = .009). Compared to precardiopulmonary bypass (pre-CPB), the odds of cerebral desaturation were notably higher during CPB (OR, 22.1, 95% CI, 12.4-39.2; P < .001) and post-CPB (OR, 18.2, 95% CI, 12.2-27.3; P < .001). However, the odds of burst suppression were lower during post-CPB (OR, 0.69, 95% CI, 0.59-0.81; P < .001) compared to pre-CPB. Compared to pre-CPB, the odds of concurrent cerebral desaturation and burst suppression were notably higher during CPB (OR, 52.3, 95% CI, 19.5-140; P < .001) and post-CPB (OR, 12.7, 95% CI, 6.39-25.2; P < .001). During CPB, the odds of cerebral desaturation (OR, 6.59, 95% CI, 3.62-12; P < .001) and concurrent cerebral desaturation and burst suppression (OR, 10, 95% CI, 4.01-25.1; P < .001) were higher in the period between removal of aortic cross-clamp and end of CPB. During the entire surgery, the odds of burst suppression increased 8 times with higher inhalational anesthesia concentration (OR, 7.81, 95% CI, 6.26-9.74; P < .001 per 0.1% increase).

conclusionsCerebral desaturation is associated with intraoperative burst suppression during cardiac surgery, most significantly during CPB, especially during the period between the removal of the aortic cross-clamp and end of CPB. Further exploration with simultaneous cerebral oximetry and EEG monitoring is required to determine the causes of burst suppression. Targeted interventions to address cerebral desaturation may assist in mitigating burst suppression and consequently enhance postoperative cognitive function.

Indexed as

BrainCardiac Surgical ProceduresCerebrovascular CirculationElectroencephalographyIntraoperative Neurophysiological MonitoringOxygen SaturationAgedCardiopulmonary BypassFemaleHumansIncidenceMaleMiddle AgedOximetryRetrospective StudiesRisk Factors

Identifiers

PMID39446661
PMCPMC11996613

What Socratic holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.