Physiological monitoring to predict postoperative delirium

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K18308
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Toho University
• Principal Investigator: SATOMOTO Maiko 東邦大学, 医学部, 准教授 (10611551)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: せん妄 / 心電図 / 予測

Outline of Final Research Achievements

The complication of postoperative delirium is directly linked to prognosis, leading to prolonged hospital stays and an increase in mortality. Since there is no magic medicine that cures delirium and the development of simple tools that enable the early assessment of the risk is valuable. Heart rate variability (HRV) is calculated based on the fluctuation of RR intervals on electrocardiogram (ECG). The HF component is considered a reflection of parasympathetic function. Then we recorded resting HRV in patients scheduled for cardiac surgery on the night before surgery. In the analysis of HRV, the HF component was significantly lower in the group with delirium compared to the group without delirium. Based on our findings, in patients with postoperative delirium, the activity of parasympathetic nerves was lower than before surgery, and we concluded that it is possible to predict the onset of postoperative delirium based on preoperative ECG measurement.

Free Research Field

医学

Academic Significance and Societal Importance of the Research Achievements

術後せん妄予測ツールの開発をテーマに研究を行い、術前から副交感神経を反映すると考えられているHF (High Frequency) の低下が認められることを世界で初めて発見した。研究を進める中で学会参加や発表をして情報収集も行った。この間、国際学会での発表が3回、国内学会での発表が3回（うち3題優秀演題）、さらに麻酔科学会及び関連学会でシンポジストとして術後せん妄の講演および教育講演も行った。心拍変動は心電図から算出され非侵襲な生体モニターであり、広くベッドサイドモニターとして普及している。心拍変動の解析は自動出力可能で、より一般的に広まり患者の安全に寄与できることが想定される。