New Study Finds That Use of Masimo SedLine® PSi and DSA May Significantly Reduce Postoperative Delirium
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Masimo Root® with SedLine® Brain Function Monitoring (Photo: Business Wire)
The researchers noted that cerebral blood supply may be “severely disrupted” during CEA, the gold standard treatment for severe carotid stenosis, and that cerebral function is “highly vulnerable” to even brief changes in oxygen and blood supply, as well as to cerebral vascular diseases like carotid stenosis. POD is a “common yet serious” type of geriatric neurological dysfunction associated with worse short- and long-term prognosis and higher healthcare costs. Noting that the incidence of POD is associated with the duration of EEG suppression during surgery, they sought to investigate whether monitoring multiple processed EEG parameters simultaneously to guide anesthesia during a procedure like CEA could positively impact the incidence of POD, compared to use of a single parameter alone.
The authors enrolled 255 patients scheduled for CEA and divided them randomly into an intervention group (n=127, mean age 62) and a standard group (n=128, mean age 63). In the intervention group, general anesthesia was managed using a combination of Masimo SedLine PSi and DSA monitoring (designed to reduce the risk of intraoperative EEG burst suppression); in the standard group, PSi without DSA monitoring was used. In both groups, patients were also monitored with continuous transcranial Doppler ultrasound and near-infrared spectroscopy (NIRS) (designed to avoid perioperative cerebral hypoperfusion or hyperperfusion). The primary outcome was the incidence of POD, measured using the Confusion Assessment Method, during the first three days after surgery. Secondary outcomes were postoperative hospital length of stay (LOS) and other neurologic complications. A team of neurophysiologists independently reviewed the EEG data acquired by SedLine to calculate the cumulative duration of burst suppression for each patient.
The researchers found that the incidence of POD was significantly lower in the intervention group (7.87% of patients) compared to the standard group (28.91% of patients, p < 0.01). Patients in the intervention group also spent significantly less overall time with EEG suppression. There was no significant difference in the incidence of other neurologic complications.
The researchers concluded, “Processed electroencephalogram-guided general anesthesia management, consisting of PSi combined with DSA monitoring, can significantly reduce the risk of postoperative delirium in patients undergoing CEA. Patients, especially those exhibiting hemodynamic fluctuations or receiving surgical procedures that disrupt cerebral perfusion, may benefit from the monitoring of multiple EEG parameters during surgery.”
Postoperative delirium is an acute state of mental confusion characterized by alterations in attention, consciousness, and disorganized thinking. A common and serious complication, POD afflicts up to 60% of patients after major surgery,2-5 is most common in the elderly,2-5 and occurs in up to 91% of the critically ill.6 POD is associated both with worse short- and long-term outcomes and higher costs,3,6-9 and numerous medical bodies—including the
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Masimo (NASDAQ: MASI) is a global medical technology company that develops and produces a wide array of industry-leading monitoring technologies, including innovative measurements, sensors, patient monitors, and automation and connectivity solutions. Our mission is to improve patient outcomes and reduce the cost of care. Masimo SET® Measure-through Motion and Low Perfusion™ pulse oximetry, introduced in 1995, has been shown in over 100 independent and objective studies to outperform other pulse oximetry technologies.20 Masimo SET® has also been shown to help clinicians reduce severe retinopathy of prematurity in neonates,21 improve CCHD screening in newborns,22 and, when used for continuous monitoring with Masimo Patient SafetyNet™ in post-surgical wards, reduce rapid response team activations, ICU transfers, and costs.23-26 Masimo SET® is estimated to be used on more than 200 million patients in leading hospitals and other healthcare settings around the world,27 and is the primary pulse oximetry at 9 of the top 10 hospitals as ranked in the 2021-22
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- Published clinical studies on pulse oximetry and the benefits of Masimo SET® can be found on our website at http://www.masimo.com. Comparative studies include independent and objective studies which are comprised of abstracts presented at scientific meetings and peer-reviewed journal articles.
- Castillo A et al. Prevention of Retinopathy of Prematurity in Preterm Infants through Changes in Clinical Practice and SpO2 Technology. Acta Paediatr. 2011 Feb;100(2):188-92.
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- Estimate: Masimo data on file.
This press release includes forward-looking statements as defined in Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, in connection with the Private Securities Litigation Reform Act of 1995. These forward-looking statements include, among others, statements regarding the potential effectiveness of