Ophthalmic and neurocognitive aspects of critically illness
Research type
Research Study
Full title
Ophthalmic and neurocognitive assessment in the management of critically ill patients
IRAS ID
251882
Contact name
Richard J Blanch
Contact email
Sponsor organisation
University of Birmingham
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
10 years, 0 months, 1 days
Research summary
Delirium sometimes occurs after surgery. Delirium is when a person has a rapid deterioration in their mental functioning often becoming agitated or drowsy. It may be caused by infections (e.g. a urinary tract infection), other acute illnesses, or prescription drugs. Post-operative delirium is common in patients undergoing major surgery and can be costly to the patient, family and NHS.\nPerioperative cognitive disorders (POCD) describes post-operative delirium, and longer term neurocognitive dysfunction after surgery. Longer term changes to a person’s brain function can also be observed up to 1 year after surgery and critical illness. How people develop delirium and postoperative neurocognitive dysfuntion is poorly understood, but may be related to cerebral vascular inflammation and disruption of the blood-brain barrier. \nWhen managing patients with infections it is vital that delivery of oxygen to critical end organs such as the heart and brain is monitored and poor delivery of oxygen is associated with a worse outcome. The retina, at the back of the eye, is part of the central nervous system and in healthy individuals retinal blood flow mirrors cerebral blood flow and is regulated in the same way. Retinal blood flow is monitored non-invasively using optical coherence tomography angiography (OCT-A).\nWe think that brain function before surgery will help to predict the development of POCD. We also think that changes in cerebral blood flow may be responsible for the development of POCD, and think that indirect measures of cerebral blood flow may help to predict, recognise and monitor POCD. \nWe will look at patients who have major surgery planned and are therefore at risk of infection and POCD. Patients will be recruited in an outpatient clinic, examined in hospital and followed for 3-6 months after their surgery.\nBy looking at patients with and without impairments in brain function before, during and after major surgery, we aim to improve patient assessment during this time as well as our understanding of the mechanisms underlying POCD and the extent to which changes in cerebral blood flow during major surgery and critical illness affect long term brain function.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
19/YH/0113
Date of REC Opinion
31 May 2019
REC opinion
Further Information Favourable Opinion