Evidence map›Paper›PMID 41236671›Full record

Trial reportGeroScience2026

Nighttime dexmedetomidine modifies the association between neurofilament light chain and delirium severity after major cardiac surgery: a secondary analysis of the MINDDS trial.

Tina B McKay, Matthew Smith, Ariel Mueller, Haobo Li, Pooja H Patel, Isaac G Freedman, Jason Z Qu, Oluwaseun Akeju

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in GeroScience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

8 authors.

Tina B McKayDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. tmckay@mgh.harvard.edu.
Matthew SmithDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Ariel MuellerDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Haobo LiDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Pooja H PatelDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Isaac G FreedmanDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Jason Z QuDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Oluwaseun AkejuDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Funding

Pathophysiology of postoperative delirium and the use of biomimetic sleep as a treatment strategy in the CSICUR01AG053582 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI JOHNSON-AKEJU, OLUWASEUN · 2016 to 2020
$4.0M
NIA NIH HHS R01 AG053582NIA NIH HHS R01AG053582
6 · The paper itself

Abstract

Postoperative delirium is a potentially devastating complication of surgery that commonly affects older adults. Neurofilament light chain (NfL) is a biomarker of neuronal injury with reported associations with the development of postoperative delirium. Previous studies suggest that nighttime dexmedetomidine may help prevent delirium following cardiac surgery. However, the mechanisms involved in the delirium-sparing properties of dexmedetomidine treatment remain unclear. This study investigated circulating NfL levels as an objective molecular biomarker associated with postoperative delirium and investigated whether nighttime dexmedetomidine moderates the association between NfL and delirium severity. Serum collected from participants aged 60 years and older who underwent cardiac surgery in the Minimizing ICU Neurological Dysfunction with Dexmedetomidine Induced Sleep (MINDDS) trial were analyzed for NfL concentrations using single-molecule immunoassays (n = 355 patients with preoperative NfL and delirium severity scores). Delirium assessments were performed using the Confusion Assessment Method (CAM). The primary outcome was the peak CAM-Severity score observed within 3 days after surgery. The analysis investigated the associations between preoperative and postoperative NfL levels and delirium severity, and whether nighttime dexmedetomidine modified these associations. Elevated preoperative NfL was associated with increased delirium incidence (odds ratio = 1.62, 95% confidence interval [1.22-2.14], p = 0.001). A one-standard-deviation increase in preoperative NfL was associated with a 0.32-point increase in CAM-S (95% confidence interval [0.14-0.50], p = 0.001). Dexmedetomidine significantly attenuated the association between preoperative NfL levels and delirium severity suggesting that dexmedetomidine may intervene early in the disease process to mitigate neuronal damage in older adults following surgery. This study provides insight into the use of preoperative NfL levels to predict delirium risk and reveals a novel interaction between dexmedetomidine treatment and delirium severity.

Indexed as

Cardiac Surgical ProceduresDeliriumDexmedetomidineHypnotics and SedativesNeurofilament ProteinsPostoperative ComplicationsAgedBiomarkersFemaleHumansMaleMiddle AgedSeverity of Illness IndexBiomarkersDexmedetomidineHypnotics and Sedativesneurofilament protein LNeurofilament ProteinsCardiac SurgeryDexmedetomidineNeurofilament light chainNeuronal InjuryPostoperative delirium

Identifiers

PMID41236671
PMCPMC13575001

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.