Individual Assignment- Literature Review Table-5 Articles

Citation	Design/Method	Sample/Setting	Major Variables Studied and Their Definitions	Measurement And Data Analysis	Findings	Results	Conclusions	Appraisal: Worth to Practice/Level
Authors: Lim L, Nam K, Lee S, et al. Year: 2020 Title: The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study. 3. Lim L, Nam K, Lee S, et al. The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study. BMC Anesthesiol. 2020;20(1):1-10. doi:10.1186/S12871-020-01180-X	Retrospective study design. The study reviewed data on patients who underwent pump coronary artery bypass graft surgery (OPCAB) in order to determine if intraoperative cerebral oximetry was associated with postoperative delirium.	815 patients who underwent OPCAB between October 2004 and December 2016. All participants were aged above 18 years. The study is a retrospective single-center study utilizing data from a hospital setting.	IV= Intraoperative cerebral oximetry DV= Postoperative delirium.	All data was analyzed using SPSS, version 23.0, for Windows (IBM Corp., Armonk, NY, USA).	The rSO2 reduction was longer in patients with delirium for the cut-offs of < 50 and 45% The proportion of patients with an rSO2 reduction < 45% among those with delirium were 228(32.1% and without 44 (41.9%), p = 0.048). Analysis of variance duration of rSO2 reduction < 45% or 50%, and delirium, the p-values of linearity were < 0.05 and the p-values of deviation from linearity were > 0.05.	There is a significant relationship between the duration of rSO2 reduction below 45% or 50% and the probability of postoperative delirium. rSO2 reduction < 45% is higher among patients with delirium	Significant intraoperative rSO2 reduction in patients undergoing OPCAB increases risk of postoperative delirium. A rSO2 reduction below 45% indicates presence of delirium.	The major limitation to the study is the influence of individual baseline psychologic values which differ from person to person and may affect rSO2 reduction. Regardless, the results of the study provide sufficient evidence that can improve practice in cardiac surgical settings including the use of cerebral oximetry monitoring to improve postoperative neurologic outcomes in cardiac surgery.
Authors: Juliana N, Yazit NAA, Kadiman S, et al. Year: 2021 Title: Intraoperative cerebral oximetry in open heart surgeries reduced postoperative complications: A retrospective study. 4. Juliana N, Yazit NAA, Kadiman S, et al. Intraoperative cerebral oximetry in open heart surgeries reduced postoperative complications: A retrospective study. PLoS One. 2021;16(5):e0251157. doi:10.1371/JOURNAL.PONE.0251157	A retrospective case-controlled study design. The study evaluated the association between cerebral oxygen monitoring during cardiac surgery and postoperative complications.	A total of 647 patients, of which 240 were intervention and 407 were control group. All participants were adults and mostly elderly aged 56+ years who had undergone open-heart surgery in National Heart Institute (NHI), Malaysia.	IV= Cerebral oxygen monitoring during cardiac surgery DV= Postoperative complications.	Data was analyzed using SPSS software version 23 (SPSS Inc., Chicage, IL). Tests included Mean ± standard deviation, independent t-test, and univariate analysis. CI was set at 95% and the level of significance set at p < 0.05.	The level of significance for the rate of postoperative complications, including in-hospital stroke, was p<0.05, renal failure needed dialysis at p<0.001, and mortality p<0.001 being higher in the control group than the case group. Logistic regression shows that the lack of cerebral oximetry monitoring during surgery increases the risk of complications. For instance, stroke OR of 7.66, renal failure needing dialysis OR of 5.12, and mortality OR score of 20.51. Gender, age, and presence of chronic conditions were found to increase the risk of complications during surgery.	The non-availability of cerebral oximetry monitoring during surgery increases the risk of complications such as stroke, renal failure needing dialysis, and mortality. Postoperative complications show that age, gender, and health status create a significant difference in the risk of complications. The use of cerebral oximetry monitoring during cardiothoracic surgeries is noted to reduce the risk of incidences of stroke, renal failure requiring dialysis, and death.	The article concludes that most complications occur during the surgery rather than post-surgery. Cerebral oxygen monitoring can reduce the risk of developing complications in open heart surgeries.	The main limitation of this study is its use of novel monitoring methods during cardiac surgery. However, its strength is in the fact that the sample population is homogenous, allowing for the drawing of generalizable conclusions. The findings of the study can inform EBP in cardiac surgical settings, including the use of cerebral oximetry monitoring to reduce the risk of complications, especially in elderly patients.
Authors: Wong ZZ, Chiong XH, Chaw SH, et al. Year: 2022 Title: The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. 5. Wong ZZ, Chiong XH, Chaw SH, et al. The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. 2022;36(7):2002-2011. doi:10.1053/J.JVCA.2021.09.046	Systematic review and meta-analysis design. Current evidence was review to explore the effect of cerebral oximetry on the incidence of postoperative cognitive dysfunction during cardiac surgeries.	A total of 14 trials presenting 2,033 participants were included in the review and meta-analysis.	IV= Cerebral oximetry DV= postoperative cognitive dysfunction during cardiac surgeries.	Statistical meta-analysis done with Review Manager (version 5.4) Outcomes were reported as odds ratio (OR) for binary outcomes. Continuous outcomes were reported as mean difference (MD). CI of 95% was maintained, and results with a P-value < 0.05 were denoted statistically significant.	POCD incidence in oximetry groups vs control group (OR: 0.15, 95%CI 0.04–0.54, P = 0.003). Risk in percentage: POCD for cerebral oximetry and control groups compared were 29.8% and 56.2%. The significance of Cerebral oximetry in reducing POCD and other cardiac-related complications was established to be higher even in 3 months postoperatively.	POCD was lower in the oximetry group as compared to the control group.	The study concludes that cerebral oximetry significantly lowers the incidence of postoperative cognitive dysfunction and other related surgical complications.	The limitations of the study include the differences in definitions of POCD and assessment tools across the included studies. However, the large heterogenous samples improve the confidence levels of the evidence. This study further informs EBP in cardiac surgical settings by further providing evidence on the application of cerebral oximetry during and post-cardiac surgery to improve outcomes as well as reduce risks of POCD and other complications.

Citation

Design/Method

Sample/Setting

Major Variables
Studied and Their Definitions

Measurement

And Data Analysis

Findings

Results

Conclusions

Appraisal:

Worth to Practice/Level

Authors: Holmgaard F, Vedel AG, Rasmussen LS, Paulson OB, Nilsson JC, Ravn HB.

Year: 2019

Title: The association between postoperative cognitive dysfunction and cerebral oximetry during cardiac surgery: a secondary analysis of a randomized trial.

1. Holmgaard F, Vedel AG, Rasmussen LS, Paulson OB, Nilsson JC, Ravn HB. The association between postoperative cognitive dysfunction and cerebral oximetry during cardiac surgery: a secondary analysis of a randomized trial. Br J Anaesth. 2019;123(2):196-205. doi:10.1016/J.BJA.2019.03.045

Secondary analysis of a randomized trial

The study analyzed data from a randomized controlled trial monitoring

cerebral blood oxygen saturation (rScO2) to prevent postoperative cognitive dysfunction (POCD) among patients aged 18 years and above who were undergoing or had undergone orthopedic surgery.

153 Participants

The study is a secondary analysis of a previous PPCI trial

IV= Cerebral oximetry during cardiac surgery

DV= postoperative cognitive dysfunction

Pre-study screening done using Mini Mental State Examination (MMSE)

POCD measured using the International Study of Postoperative Cognitive Dysfunction (ISPOCD) test battery

Data was analyzed using SPSS (version 22.0, IBM Corp., Armonk, NY, USA).

Differences in outcomes measured using the Hodges Lehmann’s estimator

Full data collected from 148 patients, 44 (29%) 95% confidence interval 22–36% had POCD at discharge, 12 (8%) 95% CI of 4–13% developed POCD in 3 months.

No significant difference in frequency of POCD between patients who did and did not experience a 10% or 20% decrease in rScO2, both at discharge and at 3 months

There lacks a significant association between intraoperative rScO2 values and POCD.

The main strength of the study is that it is a secondary analysis of a RCT.

The results can be applied in practice to guide with rScO2 monitoring and understanding the relationship between rScO2 values and risk of POCD during and post cardiac surgery

Authors: Uysal S, Lin HM, Trinh M, Park CH, Reich DL.

Year: 2020

Title: Optimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes.

2. Uysal S, Lin HM, Trinh M, Park CH, Reich DL. Optimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes. Journal of Thoracic and Cardiovascular Surgery. 2020;159(3). doi:10.1016/j.jtcvs.2019.03.036

Randomized controlled trial.

The study involved performing an intraoperative cerebral oximetry monitoring using bilateral forehead probes in cardiac surgical patients to determine if optimizing cerebral oxygenation improved neurocognitive and perioperative outcomes.

245 enrolled and 134 completed tests. Sample included patients undergoing cardiac surgery

All participants were adults aged >18 years undergoing elective cardiac surgery which

required CPB

64(48%) assigned intervention group, and70

(52%) assigned control

IV= Cerebral oxygenation. DV= Neurocognitive outcomes and perioperative outcomes

Review of preoperative patient data and operative data

cerebral oximetry data.

Evaluation of the similarities between the intervention and control groups.

The study found that there were no notable differences in perioperative, operative, and cerebral oximetry data from the intervention and control groups.

The intervention group had better mean memory change scores at 6 months.

Regardless, perioperative outcomes did not differ between intervention and control groups. Additionally, factors such as presence, duration, and severity of cerebral desaturation did not affect cognitive scores.

The article concludes that

targeted therapy optimizing cerebral oxygenation improves memory outcomes in cardiac surgical patients.

The study was terminated before it was fully concluded.

Regardless, the results of the study can guide the management of cardiac surgical patients during and after surgery to ensure better memory and cognitive outcomes post surgeries.

Authors: Lim L, Nam K, Lee S, et al.

Year: 2020

Title: The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study.

3. Lim L, Nam K, Lee S, et al. The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study. BMC Anesthesiol. 2020;20(1):1-10. doi:10.1186/S12871-020-01180-X

Retrospective study design.

The study reviewed data on patients who underwent pump coronary artery bypass graft surgery (OPCAB) in order to determine if intraoperative cerebral oximetry was associated with postoperative delirium.

815 patients who underwent OPCAB between October 2004 and December 2016.

All participants were aged above 18 years.

The study is a retrospective single-center study utilizing data from a hospital setting.

IV= Intraoperative cerebral oximetry

DV= Postoperative delirium.

All data was analyzed using SPSS, version 23.0, for Windows (IBM Corp., Armonk, NY, USA).

The rSO2 reduction was longer in patients with delirium for the cut-offs of < 50 and 45% The proportion of patients with an rSO2 reduction < 45% among those with delirium were 228(32.1% and without 44 (41.9%), p = 0.048).

Analysis of variance duration of rSO2 reduction < 45% or 50%, and delirium, the p-values of linearity were < 0.05 and the p-values of deviation from linearity were > 0.05.

There is a significant relationship between the duration of rSO2 reduction below 45% or 50% and the probability of postoperative delirium.

rSO2 reduction < 45% is higher among patients with delirium

Significant intraoperative rSO2 reduction in patients undergoing OPCAB increases risk of postoperative delirium.

A rSO2 reduction below 45% indicates presence of delirium.

The major limitation to the study is the influence of individual baseline psychologic values which differ from person to person and may affect rSO2 reduction.

Regardless, the results of the study provide sufficient evidence that can improve practice in cardiac surgical settings including the use of cerebral oximetry monitoring to improve postoperative neurologic outcomes in cardiac surgery.

Authors: Juliana N, Yazit NAA, Kadiman S, et al.

Year: 2021

Title: Intraoperative cerebral oximetry in open heart surgeries reduced postoperative complications: A retrospective study.

4. Juliana N, Yazit NAA, Kadiman S, et al. Intraoperative cerebral oximetry in open heart surgeries reduced postoperative complications: A retrospective study. PLoS One. 2021;16(5):e0251157. doi:10.1371/JOURNAL.PONE.0251157

A retrospective case-controlled study design.

The study evaluated the association between cerebral oxygen monitoring during cardiac surgery and postoperative complications.

A total of 647 patients, of which 240 were intervention and 407 were control group.

All participants were adults and mostly elderly aged 56+ years who had undergone open-heart surgery in National Heart Institute (NHI), Malaysia.

IV= Cerebral oxygen monitoring during cardiac surgery

DV= Postoperative complications.

Data was analyzed using SPSS software version 23 (SPSS Inc., Chicage, IL).

Tests included Mean ± standard deviation, independent t-test, and univariate analysis.

CI was set at 95% and the level of significance set at p < 0.05.

The level of significance for the rate of postoperative complications, including in-hospital stroke, was p<0.05, renal failure needed dialysis at p<0.001, and mortality p<0.001 being higher in the control group than the case group.

Logistic regression shows that the lack of cerebral oximetry monitoring during surgery increases the risk of complications. For instance, stroke OR of 7.66, renal failure needing dialysis OR of 5.12, and mortality OR score of 20.51.

Gender, age, and presence of chronic conditions were found to increase the risk of complications during surgery.

The non-availability of cerebral oximetry monitoring during surgery increases the risk of complications such as stroke, renal failure needing dialysis, and mortality. Postoperative complications show that age, gender, and health status create a significant difference in the risk of complications. The use of cerebral oximetry monitoring during cardiothoracic surgeries is noted to reduce the risk of incidences of stroke, renal failure requiring dialysis, and death.

The article concludes that most complications occur during the surgery rather than post-surgery.

Cerebral oxygen monitoring can reduce the risk of developing complications in open heart surgeries.

The main limitation of this study is its use of novel monitoring methods during cardiac surgery. However, its strength is in the fact that the sample population is homogenous, allowing for the drawing of generalizable conclusions.

The findings of the study can inform EBP in cardiac surgical settings, including the use of cerebral oximetry monitoring to reduce the risk of complications, especially in elderly patients.

Authors: Wong ZZ, Chiong XH, Chaw SH, et al.

Year: 2022

Title: The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

5. Wong ZZ, Chiong XH, Chaw SH, et al. The Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. 2022;36(7):2002-2011. doi:10.1053/J.JVCA.2021.09.046

Systematic review and meta-analysis design.

Current evidence was review to explore the effect of cerebral oximetry on the incidence of postoperative cognitive dysfunction during cardiac surgeries.

A total of 14 trials presenting 2,033 participants were included in the review and meta-analysis.

IV= Cerebral oximetry

DV= postoperative cognitive dysfunction during cardiac surgeries.

Statistical meta-analysis done with Review Manager (version 5.4)

Outcomes were reported as odds ratio (OR) for binary outcomes.

Continuous outcomes were reported as mean difference (MD).

CI of 95% was maintained, and results with a P-value < 0.05 were denoted statistically significant.

POCD incidence in oximetry groups vs control group (OR: 0.15, 95%CI 0.04–0.54, P = 0.003).

Risk in percentage:

POCD for cerebral oximetry and control groups compared were 29.8% and 56.2%.

The significance of

Cerebral oximetry in reducing POCD and other cardiac-related complications was established to be higher even in 3 months postoperatively.

POCD was lower in the oximetry group as compared to the control group.

The study concludes that

cerebral oximetry significantly lowers the incidence of postoperative cognitive dysfunction and other related surgical complications.

The limitations of the study include the differences in definitions of POCD and assessment tools across the included studies. However, the large heterogenous samples improve the confidence levels of the evidence.

This study further informs EBP in cardiac surgical settings by further providing evidence on the application of cerebral oximetry during and post-cardiac surgery to improve outcomes as well as reduce risks of POCD and other complications.

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Question

Purpose: Two-dimensional literature tables provide insights into important themes in the collected data across studies.
Task: Create a two-dimensional evidence summary table/ matrix of 5 research articles that directly reflect the assigned topic/research problem. Rows are used for individual studies, and columns are used to insert relevant data about each study.

Individual Assignment- Literature Review Table-5 Articles

Criteria:
Utilize the five (5) studies appraised in the Article Critique assignment to create a literature review table (you guys worked on the article critique, I’ll attach it below, so you will be using the same articles)
Use the Table of evidence template to create the literature table (Template attached below)
A table row should exist for each study. Display in Landscape format to adequately display all table columns on a page.
The book for the class is also attached.

Individual Assignment- Literature Review Table-5 Articles

Individual Assignment- Literature Review Table-5 Articles

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