Neuroprotection role of cooling helmet on neuron specific enolase (NSE) and post-surgery delirium levels in open heart surgery patients: a randomized controlled trial

  • Mohamad Prakoso Adji
  • Jefferson Kasan Hidayat
  • Aldy Heriwardito
Keywords: Adult, Brain / physiopathology, Brain / enzymology, Brain Injuries / therapy, Delirium, Head Protective Devices, Humans, Hypothermia, Induced / instrumentation, Immunoenzyme Techniques, Isoenzymes / analysis

Abstract

Background & objective: This study aims to assess the effect of cooling helmet during surgery on neuron specific enolase (NSE) and delirium levels following open heart surgery patients with cardiopulmonary bypass (CPB) using a heart-lung machine.

Methodology: This double-blind randomized clinical trial took place from October to December 2021 in a tertiary care hospital. The research used a modified cooling helmet to decrease brain temperature. Inclusion criteria were adult patients who were scheduled for open heart surgery with CPB. The subjects were randomized into two groups: patients with the cooling helmet on as the treatment group (n = 12) and the patients with the non-cooling helmet on as the control group (n = 13). The differences between NSE and delirium levels in both groups were assessed at specific times.

Results: NSE levels in the treatment group were lower than the control group (7.13 ± 7.63 vs. 12.49 ± 6.81; P < 0.05). Regarding the delirium, no statistically significant difference was found in both groups (P > 0.05).

Conclusion: The hypothermia effect of the cooling helmet is associated with a decrease of neuron specific enolase levels, but it did not significantly correlate to prevent the delirium after open heart surgery patients with the cardiopulmonary bypass machine.

Abbreviations: CABG: coronary artery bypass graft; CPB: Cardiopulmonary Bypass; CMRO2: cerebral metabolic rate of oxygen; HLM: Heart-lung machine; NSE: Neuron Specific Enolase; ROS: reactive oxygen species

Citation: Adji MP, Hidayat JK, Heriwardito A. Neuroprotection role of cooling helmet on neuron specific enolase (NSE) and post-surgery delirium levels in open heart surgery patients: a randomized controlled trial. Anaesth. pain intensive care 2022;26(5):588-594; DOI: 10.35975/apic.v26i5.1985

Author Biographies

Jefferson Kasan Hidayat

Jefferson Kasan Hidayat, Department of Anesthesiology and Intensive Care, Universitas Indonesia, Jakarta, Indonesia

Aldy Heriwardito

Aldy Heriwardito, Department of Anesthesiology and Intensive Care, Universitas Indonesia, Jakarta, Indonesia

Published
10-18-2022
How to Cite
Adji, M., Hidayat, J., & Heriwardito, A. (2022). Neuroprotection role of cooling helmet on neuron specific enolase (NSE) and post-surgery delirium levels in open heart surgery patients: a randomized controlled trial. Anaesthesia, Pain & Intensive Care, 26(5), 588-594. https://doi.org/10.35975/apic.v26i5.1985
Section
ORIGINAL RESEARCH