Evidence map›Paper›PMID 34503835›Full record

ArticleBritish journal of anaesthesia2021

Anaesthetic depth and delirium: a challenging balancing act.

Elizabeth L Whitlock, Eric R Gross, C Ryan King, Michael S Avidan

Abstract readEditorialComment
PubMed Publisher
In one paragraph

Article in British journal of anaesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
4.1field-weighted citation impact, top 5% 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.

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

4 citing papers in PubMed, 18 citations in OpenAlex.

  1. Review
  2. A Real-Time Neurophysiologic Stress Test for the Aging Brain: Novel Perioperative and ICU Applications of EEG in Older Surgical Patients.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2023
    Review
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Elizabeth L WhitlockDepartment of Anesthesia & Perioperative Care, University of California, School of Medicine, San Francisco, CA, USA.
Eric R GrossDepartment of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Stanford, CA, USA.
C Ryan KingDepartment of Anesthesiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
Michael S AvidanDepartment of Anesthesiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA. Electronic address: avidanm@wustl.edu.
Washington University in St. Louis · USStanford University · USUniversity of California, San Francisco · US

Funding

Institutional Career Development Core SupplementKL2TR001870 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KANAYA, ALKA M., SARKAR, URMIMALA · 2016 to 2025
$19.7M
Precision Targeting of Aldehyde Pathways for Patients Requiring AnesthesiaR35GM119522 · NIGMS · STANFORD UNIVERSITY · PI Eric Richard Gross · 2016 to 2026
$5.1M
TRAINING PROGRAM IN ANESTHESIOLOGY RESEARCHT32GM108539 · NIGMS · WASHINGTON UNIVERSITY · PI Aaron J Norris · 2014 to 2026
$4.9M
NCATS NIH HHS KL2 TR001870NIGMS NIH HHS R35 GM119522NIGMS NIH HHS T32 GM108539
6 · The paper itself

Abstract

This editorial highlights the findings of the Balanced Anaesthesia Delirium study, a 515-patient substudy of the 6644 patient Balanced Anaesthesia trial, which found that targeting deep anaesthesia in patients undergoing major noncardiac surgery was not associated with significantly increased postoperative death or major morbidity. The substudy found that using bispectral index (BIS) guidance with the intention of deliberately achieving deep volatile agent-based anaesthesia (target BIS reading 35 vs 50) significantly increased delirium incidence (28% vs 19%), although not subsyndromal delirium incidence (45% vs 49%). We discuss the implications of these findings for anaesthetic practice, and address whether the BIS should be used as a guide to deliver precision anaesthesia for delirium prevention. We posit that subpopulation-based differences within this multicentre substudy could have affected delirium occurrence, since the findings appeared to rest on outcomes in patients from East Asia. We conclude that questions of whether and for whom deep anaesthesia is deliriogenic remain unanswered.

Indexed as

AnesthesiologyAnestheticsDeliriumAnesthesia, GeneralHumansAnestheticsanaesthetic sensitivitybispectral indexdeliriumdepth of anaesthesiaprecision medicine

Identifiers

PMID34503835
OpenAlexW3198539083

What OpenQuestion 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 OpenQuestion graph.