To know the relationship between the use of cooling helmet with the changes of NSE level and postoperative delirium event in open heart surgery

Subjects were assigned into two groups after giving consent to participate in the study using random allocation, 13 subjects per group. Blood sample from CVC were obtained to assess NSE preoperative. After induction, cooling helmet with circulating cold water were placed on patients group A and without circulating cold water on group B. Blood samples were obtain again 6 hours after cardiopulmonary bypass off to assess NSE postoperative. Delirium was assessed using Confusion Assessment Method - Intensive Care Unit (CAM-ICU)

Inclusion Criteria:

• Patient undergoing their first open heart surgery using cardiopulmonary bypass
• Age ≥18 year-old
• Patient with American Society of Anesthesiologists (ASA) III
• Patient with Glasgow Coma Scale (GCS) 15, fully aware and oriented
• Patient fluent in Indonesia

Exclusion Criteria:

• Patients did not give consent to participate in the study
• Patients with central nervous system disease (stroke, intracranial tumor)
• Patients with psychiatric problem (schizophrenia, depression)
• Patients with cognitive problem
• Blind and deaf patient
• Patient on psychotrophic or narcotics medication

Drop out criteria

• Surgery without cardiopulmonary bypass
• Patient demise after surgery
• Patients decided to refrain from the study