Delirium, Electroencephalographic Alterations and Cortical Spreading Depression (CSD) in Critical Illness
Delirium in the intensive care unit is an acutely developed brain dysfunction affecting up to 80 % of patients. It is associated with significantly increased morbidity and mortality during admission and post-discharge. The mechanism behind the condition is poorly understood but assumably multifactorial, and the purpose of this study is to investigate the pathophysiology further.
|Study Type:||Observational [Patient Registry]|
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Target Follow-Up Duration:||1 Year|
|Official Title:||Delirium, Electroencephalographic Alterations and Cortical Spreading Depression in Critical Illness|
- The occurence of electroencephalographic alterations and potential electroencephalographic signatures prior to and during delirium in the ICU [ Time Frame: 7 days ] [ Designated as safety issue: No ]
- The occurence of cortical spreading depression in noninvasive direct current-EEG in critically ill patients without acute cerebral trauma [ Time Frame: Cortical spreading depression in the ICU ] [ Designated as safety issue: No ]
- Comparing electroencephalographic and electrocortical recordings in neurointensive care [ Time Frame: Delirium - a clinical manifestation of cortical spreading depression? ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples With DNA
Blood, cerebrospinalfluid, urine
|Study Start Date:||October 2013|
|Estimated Study Completion Date:||February 2016|
|Estimated Primary Completion Date:||September 2015 (Final data collection date for primary outcome measure)|
The pathophysiology behind delirium in critical illness is not clarified but assumed to involve inflammation, changes in cerebral perfusion and neurotransmission, sleep deprivation and the use of i.e. sedatives.
Cortical spreading depression is a phenomenon occuring in critically ill patients with acute cerebral trauma and likely associated with significant secondary neuron damage.
The hypothesis is that
- Delirium in critically ill patients without acute cerebral damage is a clinical manifestation of cortical spreading depression and can be recorded in a noninvasive direct current-electroencephalography
- Electroencephalographic alterations or potentially specific signatures occur in delirium and thus, delirium can be predicted by recording continuous alternate current electroencephalography on admission in an ICU
|Glostrup Hospital, University of Copenhagen||Recruiting|
|Glostrup, Denmark, DK-2600|
|Contact: Rikke M Nielsen, MD +45 51 900 551 firstname.lastname@example.org|
|Study Director:||Kirsten Moller, MD, PhD||Department of Neuroanaesthesiology 2093, Rigshospitalet, Denmark|