Optimizing Cerebral Autoregulation During Surgery

Johns Hopkins University

Status: Completed

Conditions: Hip Fractures; Delirium; Hip Arthropathy; Surgery

Treatments: Other: Blood pressure management according to cerebral autoregulation; Other: Blood pressure management according to usual care

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT05308290

K76AG057020 (U.S. NIH Grant/Contract)

IRB00137091

Details and patient eligibility

About

The purpose of this study is to conduct a pilot trial to determine the feasibility, safety, and potential efficacy of targeting mean arterial blood pressure (MAP) within the limits of cerebral autoregulation during surgery compared with usual care.

Enrollment: 27 patients

Sex: All

Ages: 60 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• planned hip or knee surgery (either for fracture or elective) or lung surgery
• age ≥60
• ambulatory at baseline
• expected duration of surgery > 90 minutes

Exclusion criteria

• Planned concurrent surgery
• Allergy to adhesive tape
• Short Blessed Test score >20
• Clinical diagnosis of dementia
• Opinion of either the anesthesiologist or surgeon that the patient is not appropriate.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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27 participants in 2 patient groups

Blood pressure managed by cerebral autoregulation

Experimental group

Description:

In this arm cerebral autoregulation monitoring will be used to determine the lower and upper limits of cerebral autoregulation. Monitoring will continue throughout the surgery. Blood pressure management will be maintained to be within the limits of cerebral autoregulation.

Treatment:

Other: Blood pressure management according to cerebral autoregulation

Standard of care blood pressure management

Active Comparator group

Description:

In this arm cerebral autoregulation monitoring will be used for observation. The anesthesia provider will use usual care guidelines for blood pressure management.

Treatment:

Other: Blood pressure management according to usual care