IMR Press / RCM / Volume 25 / Issue 4 / DOI: 10.31083/j.rcm2504126
Open Access Systematic Review
Electroencephalography Monitoring for Preventing Postoperative Delirium and Postoperative Cognitive Decline in Patients Undergoing Cardiothoracic Surgery: A Meta-Analysis
Song Xue1,2Ao-xue Xu1,2Hong Liu3,*Ye Zhang1,2,*
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1 Department of Anesthesiology and Perioperative Medicine, The Second Hospital of Anhui Medical University, 230061 Hefei, Anhui, China
2 Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 230038 Hefei, Anhui, China
3 Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA 95817, USA
*Correspondence: (Hong Liu); (Ye Zhang)
Rev. Cardiovasc. Med. 2024, 25(4), 126;
Submitted: 29 September 2023 | Revised: 26 November 2023 | Accepted: 6 December 2023 | Published: 29 March 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Patients undergoing cardiothoracic surgery frequently encounter perioperative neurocognitive disorders (PND), which can include postoperative delirium (POD) and postoperative cognitive decline (POCD). Currently, there is not enough evidence to support the use of electroencephalograms (EEGs) in preventing POD and POCD among cardiothoracic surgery patients. This meta-analysis examined the importance of EEG monitoring in POD and POCD. Methods: Cochrane Library, PubMed, and EMBASE databases were searched to obtain the relevant literature. This analysis identified trials based on the inclusion and exclusion criteria. The Cochrane tool was used to evaluate the methodological quality of the included studies. Review Manager software (version 5.3) was applied to analyze the data. Results: Four randomized controlled trials (RCTs) were included in this meta-analysis, with 1096 participants. Our results found no correlation between EEG monitoring and lower POD risk (relative risk (RR): 0.81; 95% CI: 0.55–1.18; p = 0.270). There was also no statistically significant difference between the EEG group and the control group in the red cell transfusions (RR: 0.86; 95% CI: 0.51–1.46; p = 0.590), intensive care unit (ICU) stay (mean deviation (MD): –0.46; 95% CI: –1.53–0.62; p = 0.410), hospital stay (MD: –0.27; 95% CI: –2.00–1.47; p = 0.760), and mortality (RR: 0.33; 95% CI: 0.03–3.59; p = 0.360). Only one trial reported an incidence of POCD, meaning we did not conduct data analysis on POCD risk. Conclusions: This meta-analysis did not find evidence supporting EEG monitoring as a potential method to reduce POD incidence in cardiothoracic surgery patients. In the future, more high-quality RCTs with larger sample sizes are needed to validate the relationship between EEG monitoring and POD/POCD further.

electroencephalography monitoring
postoperative delirium
postoperative cognitive decline
cardiothoracic surgery
cognitive dysfunction
postoperative cognitive complications
cognition disorders
81970231/National Natural Science Foundation of China
2308085MH260/Anhui Provincial Natural Science Foundation
Fig. 1.
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