{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:20:44Z","timestamp":1786123244170,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","funder":[{"name":"NIH","award":["5R01AG065554"],"award-info":[{"award-number":["5R01AG065554"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Increased intraoperative electroencephalographic (EEG) burst suppression is associated with postoperative delirium. Cerebral desaturation is considered as one of the factors associated with burst suppression. Our study investigates the association between cerebral desaturation and burst suppression by analyzing their concurrence. Additionally, we aim to examine their association with cardiac surgical phases to identify potential for targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed intraoperative 1-minute interval observations in 51 patients undergoing cardiac surgery. Processed EEG and cerebral oximetry were collected, with the anesthesiologists blinded to the information. The associations between cerebral desaturation (defined as a 10% decrease from baseline) and burst suppression, as well as with phase of cardiac surgery, were analyzed using the Generalized Logistic Mixed Effect Model. The results were presented as odds ratio and 95% confidence intervals (CIs). A value of\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05 was considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The odds of burst suppression increased 1.5 times with cerebral desaturation (odds ratio [OR], 1.52, 95% CI, 1.11\u20132.07;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .009). Compared to precardiopulmonary bypass (pre-CPB), the odds of cerebral desaturation were notably higher during CPB (OR, 22.1, 95% CI, 12.4\u201339.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and post-CPB (OR, 18.2, 95% CI, 12.2\u201327.3;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). However, the odds of burst suppression were lower during post-CPB (OR, 0.69, 95% CI, 0.59\u20130.81;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) compared to pre-CPB. Compared to pre-CPB, the odds of concurrent cerebral desaturation and burst suppression were notably higher during CPB (OR, 52.3, 95% CI, 19.5\u2013140;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and post-CPB (OR, 12.7, 95% CI, 6.39\u201325.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). During CPB, the odds of cerebral desaturation (OR, 6.59, 95% CI, 3.62\u201312;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and concurrent cerebral desaturation and burst suppression (OR, 10, 95% CI, 4.01\u201325.1;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) were higher in the period between removal of aortic cross-clamp and end of CPB. During the entire surgery, the odds of burst suppression increased 8 times with higher inhalational anesthesia concentration (OR, 7.81, 95% CI, 6.26\u20139.74;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 per 0.1% increase).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Cerebral desaturation is associated with intraoperative burst suppression during cardiac surgery, most significantly during CPB, especially during the period between the removal of the aortic cross-clamp and end of CPB. Further exploration with simultaneous cerebral oximetry and EEG monitoring is required to determine the causes of burst suppression. Targeted interventions to address cerebral desaturation may assist in mitigating burst suppression and consequently enhance postoperative cognitive function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1213\/ane.0000000000007209","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T13:49:15Z","timestamp":1729777755000},"page":"1086-1092","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Incidence of Concurrent Cerebral Desaturation and Electroencephalographic Burst Suppression in Cardiac Surgery Patients"],"prefix":"10.1213","volume":"140","author":[{"given":"Rushil Vladimir","family":"Ramachandran","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkananda","family":"Behera","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaid","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Peck","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Ananthakrishanan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyam","family":"Mathur","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Banner-Goodspeed","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Danny","family":"Muehlschlegel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Francois","family":"Pittet","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Bardia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Schonberger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Marcantonio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kestutis","family":"Kveraga","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balachundhar","family":"Subramaniam","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"suppl 1)","key":"R1-20250414","doi-asserted-by":"crossref","first-page":"i41","DOI":"10.1093\/bja\/aep291","article-title":"Postoperative delirium and cognitive dysfunction.","volume":"103","author":"Deiner","year":"2009","journal-title":"Br J 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