Analysis of Unplanned Perioperative Hypothermia effects on Post Operative Delirium through the use of biomarkers

Abstract (300 words maximum)

Unplanned perioperative hypothermia (UPH) is the unintentional drop in the body’s temperature (below 36°C) during surgery (> 50 minutes). One retrospective study shows a relationship between post operative delirium (POD) and UPH. Critically ill younger patients who experienced UPH had a higher incidence of POD than critically ill older patients which warranted clinical investigation. The goal of our study is to investigate the relationship amongst various biomarkers, UPH, and POD in a clinical sample of critically ill non-cardiac adult patients with and without POD to determine the influence of UPH on POD development. Biomarker’s indicative of inflammatory and oxidative stress will be explored. The inflammatory biomarkers being studied are IL6, S100B, and CRP. The oxidative stress biomarkers include protein carbonyl and HNE protein adduct. Our research is divided into two distinct phases: clinical assessment and laboratory analysis. The clinical portion consists of 100 surgical patients who will have temperature and POD clinical data recorded throughout and after surgery. These patients will have blood drawn and a delirium assessment administered three days postoperatively. In the lab, we will prepare serum from whole blood samples, that will be analyzed for the presence of biomarkers using enzyme-linked immunoassay (ELISA) approaches. These assays use sandwich, indirect, and competitive ELISAs kits. Based on the standard curve regression line, the concentration of the unknown patient samples will be calculated. Here we present the preliminary findings based on the expected normal ranges for each biomarker in preparation for patient samples. Patient samples may be diluted for analysis.

Academic department under which the project should be listed

WCHHS - Nursing

Primary Investigator (PI) Name

Doreen Wagner

Additional Faculty

Sharon Pearcey, Psychological Science, spearcey@kennesaw.edu

Susan M.E Smith, Molecular and Cellular Biology, ssmit325@kennesaw.edu

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Analysis of Unplanned Perioperative Hypothermia effects on Post Operative Delirium through the use of biomarkers

Unplanned perioperative hypothermia (UPH) is the unintentional drop in the body’s temperature (below 36°C) during surgery (> 50 minutes). One retrospective study shows a relationship between post operative delirium (POD) and UPH. Critically ill younger patients who experienced UPH had a higher incidence of POD than critically ill older patients which warranted clinical investigation. The goal of our study is to investigate the relationship amongst various biomarkers, UPH, and POD in a clinical sample of critically ill non-cardiac adult patients with and without POD to determine the influence of UPH on POD development. Biomarker’s indicative of inflammatory and oxidative stress will be explored. The inflammatory biomarkers being studied are IL6, S100B, and CRP. The oxidative stress biomarkers include protein carbonyl and HNE protein adduct. Our research is divided into two distinct phases: clinical assessment and laboratory analysis. The clinical portion consists of 100 surgical patients who will have temperature and POD clinical data recorded throughout and after surgery. These patients will have blood drawn and a delirium assessment administered three days postoperatively. In the lab, we will prepare serum from whole blood samples, that will be analyzed for the presence of biomarkers using enzyme-linked immunoassay (ELISA) approaches. These assays use sandwich, indirect, and competitive ELISAs kits. Based on the standard curve regression line, the concentration of the unknown patient samples will be calculated. Here we present the preliminary findings based on the expected normal ranges for each biomarker in preparation for patient samples. Patient samples may be diluted for analysis.

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