Effects of cardiopulmonary bypass and hypothermia on electroencephalographic variables

Doi, Matsuyuki; Gajraj, R. J.; Mantzaridis, H.; Kenny, G. N. C.

doi:10.1111/j.1365-2044.1997.229-az0364.x

Cited by 69 publications

(38 citation statements)

References 28 publications

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“…Mathew et al showed BIS to decrease by 1.12 units per°C decline [14]. The accuracy of brain monitors in general has been shown to be lower during moderate cooling [15]. Our patients were moderately cold, at about 34°C, a temperature that should not result in significant changes.…”

Section: Discussionmentioning

confidence: 98%

Clinical comparison of three different anaesthetic depth monitors during cardiopulmonary bypass

et al. 2005

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SummaryThe lack of a gold standard complicates the evaluation and comparison of anaesthetic depth monitors. This randomised study compares three different depth-of-anaesthesia monitors during cardiopulmonary bypass (CPB) at 34°C with fentanyl ⁄ propofol anaesthesia adjusted clinically and blinded to the monitors. Coronary artery bypass grafting patients (n = 21) were randomly assigned to all three possible paired combinations of three monitors: Bispectral Index (Aspect Medical), AAI TM auditory evoked potential (Danmeter), Entropy TM (Datex-Ohmeda). Indices were manually recorded every 5 min during CPB. Agreement between paired indices was classified as good, non-, or disagreement. Anaesthesia was classed as adequate, inadequate, or excessive according to recommended index values. Of the 255 paired indices recorded, 62% showed good agreement, 33% showed non-agreement, and 5% showed disagreement. Using good agreement between two monitors as a gold standard, a quarter of the measurements indicate inappropriate anaesthetic depth monitoring during CPB with clinically titrated anaesthetic depth.

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Section: Discussionmentioning

confidence: 98%

Clinical comparison of three different anaesthetic depth monitors during cardiopulmonary bypass

et al. 2005

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“…During CPB, sevoflurane was administered through the oxygenator. The depth of anaesthesia before, during and after CPB was controlled at AEPi 30–40, 15–30 and 30–40 by adjusted inhaled sevoflurane concentration, respectively [16–19]. In the propofol group, anaesthesia was maintained with propofol at a infusion rate of 3–10 mg · kg −1 · h −1 , and fentanyl (5–10 μg kg −1 ) and vecuronium 0.1 mg kg −1 boli as needed; the depth of anaesthesia before, during and after CPB was also controlled at AEPi 30–40, 15–30 and 30–40 by adjusted the infusion rate of propofol, respectively.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the myocardial protective effect of sevoflurane versus propofol in patients undergoing heart valve replacement surgery with cardiopulmonary bypass

et al. 2017

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BackgroundThis study aimed to compare myocardial protective effects of anaesthesia with intravenous infusion of propofol versus inhalation of sevoflurane in patients undergoing heart valve replacement surgery with cardiopulmonary bypass.MethodsSeventy-six patients undergoing valve replacement with cardiopulmonary bypass were randomly assigned to propofol or sevoflurane anesthesia during the surgery, respectively. For assessing myocardial injury, cardiac troponin I (cTnI) and creatine kinase isozyme (CK-MB) were determined before induction (T0), 0.5 h (T1) and 3 h (T2) after aortic unclamping, and 24 h (T3) and 48 h (T4) after surgery. The concentrations of interleukin (IL)-6 and IL-10 as the systemic inflammatory and anti-inflammatory markers were also measured at above time points.ResultsIn the sevoflurane group, the plasma concentrations of cTnI and CK-MB from Tl to T4 and the levels of IL-6 and IL-10 from T1 to T2 were lower than those in the propofol group. Moreover, a higher ratio of automatic heart beat recovery and a shorter length of intensive care unit or hospital stay were found in the sevoflurane group comparing with the propofol group.ConclusionSevoflurane anaesthesia produced more prominent myocardial protection and attenuated inflammatory response than propofol anaesthesia in patients with valve replacement surgery under cardiopulmonary bypass, resulting in shorter ICU and in-hospital stay.Retrospective clinical trial registrationIdentified as ChiCTR-IOR-16009979 at http://www.chictr.org.cn/.

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“…Physiological conditions, such as age [81,82], race [83,84], gender [85–87], low core body temperature [88], acid-base imbalances [89–91], low blood glucose [92,93] or brain ischemia [62] also have a significant effect on the raw EEG. Drugs administered to the patient can influence the EEG either through a direct mechanism on the raw EEG [94,95] or by interacting with the absorption, distribution and elimination of the general anaesthetic drug [96].…”

Section: Key Considerations When Designing and Evaluating Dga Monitorsmentioning

confidence: 99%

Monitoring the Depth of Anaesthesia

Musizza

Ribarič

2010

Sensors

111

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One of the current challenges in medicine is monitoring the patients’ depth of general anaesthesia (DGA). Accurate assessment of the depth of anaesthesia contributes to tailoring drug administration to the individual patient, thus preventing awareness or excessive anaesthetic depth and improving patients’ outcomes. In the past decade, there has been a significant increase in the number of studies on the development, comparison and validation of commercial devices that estimate the DGA by analyzing electrical activity of the brain (i.e., evoked potentials or brain waves). In this paper we review the most frequently used sensors and mathematical methods for monitoring the DGA, their validation in clinical practice and discuss the central question of whether these approaches can, compared to other conventional methods, reduce the risk of patient awareness during surgical procedures.

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Effects of cardiopulmonary bypass and hypothermia on electroencephalographic variables

Cited by 69 publications

References 28 publications

Clinical comparison of three different anaesthetic depth monitors during cardiopulmonary bypass

Clinical comparison of three different anaesthetic depth monitors during cardiopulmonary bypass

Comparison of the myocardial protective effect of sevoflurane versus propofol in patients undergoing heart valve replacement surgery with cardiopulmonary bypass

Monitoring the Depth of Anaesthesia

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