Evidence map›Paper›PMID 29912008›Full record

SynthesisAnesthesiology2018

Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.

Kristen K MacKenzie, Angelitta M Britt-Spells, Laura P Sands, Jacqueline M Leung

5 registry-linked trialsOpen access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Anesthesiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 48 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 6 pooled it
8.9field-weighted citation impact, top 2% of its field
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.

NCT03840577 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Effect of Bispectral Index (BIS)-Guided Sedation on Delirium and Sedative Drug Requirements in Critically Ill Patients Under Deep Sedation

TypeinterventionalSponsorHospital Italiano de Buenos AiresRan2019 to 2024Enrolled99ConditionsDelirium, Sedative OverdoseArmsMonitorization of sedation by Bispectral Index
NCT04016740 early_phase1completednot on this mapstarted 2019, after this paper: background citation

Perioperative Multimodal General Anesthesia Focusing on Specific CNS Targets in Patients Undergoing Cardiac Surgeries

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2019 to 2020Enrolled22ConditionsCoronary Artery Disease, DeliriumArmsRopivacaine, Ketamine, Remifentanil, Dexmedetomidine, Rocuronium
NCT04643834 completednot on this mapstarted 2019, after this paper: background citation

Validation of Cerebral Non-invasive Monitoring and Prediction of Post-operative Delirium and Outcomes: A Prospective Observational Study

TypeobservationalSponsorMontreal Heart InstituteRan2019 to 2023Enrolled153ConditionsDelirium, Cerebral Desaturation, EEG With Abnormally Slow Frequencies
NCT05051982 nacompletednot on this mapstarted 2021, after this paper: background citation

SedLine EEG-Guided Depth of Anesthesia: Effect of Anesthetic Dosage

TypeinterventionalSponsorIndiana UniversityRan2021 to 2022Enrolled110ConditionsAnesthesia, SurgeryArmsSedline EEG in View
NCT05279898 nacompletednot on this mapstarted 2023, after this paper: background citation

Perioperative Multimodal General AnesTHesia Focusing on Specific CNS Targets in Patients Undergoing carDiac surgERies - the PATHFINDER II Study

TypeinterventionalSponsorBeth Israel Deaconess Medical CenterRan2023 to 2024Enrolled70ConditionsPostoperative Delirium, Hemodynamic Instability, Pain, Neurocognitive DysfunctionArmsEEG Monitoring, Ropivacaine, Ketamine, Remifentanil, Dexmedetomidine
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 112 citations in OpenAlex.

  1. Pooled it
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  7. Trial
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  15. Molecular and Clinical Considerations for Anesthesia in the Aging Brain.International journal of molecular sciences · 2025
    Review
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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

4 authors at 1 institution in 1 country.

Kristen K MacKenzieFrom the Department of Anesthesia and Perioperative Care, University of California, San Francisco, California (K.K.M., J.M.L.) Department of Kinesiology, University of Indianapolis, Indianapolis, Indiana (A.M.B.-S.) Virginia Polytechnic Institute and State University, Center for Gerontology, Blacksburg, Virginia (L.P.S.).
Angelitta M Britt-Spells
Laura P Sands
Jacqueline M Leung
May Institute · US

Funding

The Effects of Light vs Deep Anesthesia on Postoperative Cognitive OutcomesR21AG048456 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEUNG, JACQUELINE M · 2015 to 2016
$444k
Acute preoperative sleep disruption and postoperative deliriumR21AG053715 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEUNG, JACQUELINE M · 2017 to 2018
$439k
NIA NIH HHS R21 AG048456NIA NIH HHS R21 AG053715
6 · The paper itself

Abstract

what we already know about this topicWHAT THIS ARTICLE TELLS US THAT IS NEW:

background: Postoperative delirium complicates approximately 15 to 20% of major operations in patients at least 65 yr old and is associated with adverse outcomes and increased resource utilization. Furthermore, patients with postoperative delirium might also be at risk of developing long-term postoperative cognitive dysfunction. One potentially modifiable variable is use of intraoperative processed electroencephalogram to guide anesthesia. This systematic review and meta-analysis examines the relationship between processed electroencephalogram monitoring and postoperative delirium and cognitive dysfunction.

methodsA systematic search for randomized controlled trials was conducted using Ovid MEDLINE, PubMed, EMBASE, Cochrane Library, and Google search using the keywords processed electroencephalogram, Bispectral Index, postoperative delirium, postoperative cognitive dysfunction. Screening and data extraction were conducted by two independent reviewers, and risk of bias was assessed. Postoperative delirium combined-effect estimates calculated with a fixed-effects model were expressed as odds ratios with 95% CIs.

resultsThirteen of 369 search results met inclusion criteria. Postoperative cognitive dysfunction data were excluded in meta-analysis because of heterogeneity of outcome measurements; results were discussed descriptively. Five studies were included in the quantitative postoperative delirium analysis, with data pooled from 2,654 patients. The risk of bias was low in three studies and unclear for the other two. The use of processed electroencephalogram-guided anesthesia was associated with a 38% reduction in odds for developing postoperative delirium (odds ratio = 0.62; P < 0.001; 95% CI, 0.51 to 0.76).

conclusionsProcessed electroencephalogram-guided anesthesia was associated with a decrease in postoperative delirium. The mechanism explaining this association, however, is yet to be determined. The data are insufficient to assess the relationship between processed electroencephalogram monitoring and postoperative cognitive dysfunction.

Indexed as

Anesthesia, GeneralElectroencephalographyEmergence DeliriumHumansMonitoring, IntraoperativeRandomized Controlled Trials as Topic

Identifiers

PMID29912008
PMCPMC6092196
OpenAlexW2808314891

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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 OpenQuestion graph.