Electroencephalographic Monitoring of Cerebral Function During Asystole and Successful Cardiopulmonary Resuscitation

LoSasso, Thomas; Muzzi, Donald A.; Meyer, Frederic B.; Sharbrough, Frank W.

doi:10.1213/00000539-199212000-00025

Cited by 47 publications

(39 citation statements)

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“…However, probably due to the complexity of electrode placement and interpretation, there have been very few case reports [3,4] or human studies [5] on the relationship between EEG and the state of cerebral perfusion in anaesthetised patients. BIS, derived from multivariate analysis of rolling .............................................................................................................................................................................................................. [6], decreases in its value during hypotension or cardiac arrest [1,7], analogous to the EEG changes above, have been reported.…”

Section: Discussionmentioning

confidence: 99%

The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion

Azim

Wang

2004

Anaesthesia

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SummaryA 62-year-old male underwent off-pump coronary artery grafting surgery while cerebral function was monitored with bispectral index (BIS). The BIS monitoring was continued into the immediate postoperative period, during which time the patient experienced a cardiopulmonary arrest. The changes in the BIS values helped the resuscitating team in assessing the cerebral response to the cardiopulmonary resuscitation.

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Section: Discussionmentioning

confidence: 99%

The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion

Azim

Wang

2004

Anaesthesia

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“…In humans, EEG is suppressed within seconds of CA (Clute and Levy, 1990, Losasso et al, 1992, Moss and Rockoff, 1980) and recovers via an initial periodic bursting pattern that precedes restitution of continuous activity (Jorgensen and Malchow-Moller, 1981a). This transition from burst-suppression to continuous EEG precedes arousal by hours to days (Jorgensen and Malchow-Moller, 1981b).…”

Section: Introductionmentioning

confidence: 99%

Intraventricular orexin-A improves arousal and early EEG entropy in rats after cardiac arrest

et al. 2009

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The recovery of arousal after cardiac arrest (CA) is associated with evolution from electroencephalographic (EEG) burst-suppression to continuous activity. Orexin-A elicits arousal EEG during anesthetic burst-suppression. We hypothesized that orexin-A would improve arousal and EEG entropy after CA. Eighteen Wistar rats were subjected to 7-minute asphyxial CA and resuscitation. Rats were divided into treatment (n=9) and control (n=9) groups. Twenty minutes after resuscitation, the treatment group received 0.1 mL of 1nM orexin-A intraventricularly, while controls received saline. EEG was quantified using Information Quantity (IQ), a measure of entropy validated for detection of burst-suppression and arousal patterns. IQ values range from 0–1.0. Arousal was quantified using the neurological deficit scale (NDS). The ischemic neuronal fraction of hippocampus CA1 and cortex was histologically determined. Baseline and post-resuscitation characteristics were similar between the groups. The NDS score (mean±SD) at 4 hours was higher in the orexin-A group compared to controls (57.3±5.8 vs. 40.7±5.9, p<0.02), but scores were similar at 72 hours. Burst frequency was similar in both groups but the orexin-A group demonstrated higher IQ values compared to controls beginning within 10 minutes. IQ values remained significantly higher in the orexin-A group for the first 120 minutes (p=0.008) and subsequently converged. The ischemic neuronal fraction was similar between groups in cortex (p=0.54) and hippocampus CA1 (p=0.14). In rats resuscitated from CA, orexin-A transiently increased arousal and EEG entropy without worsening ischemic neuronal injury. The role of orexin-A in recovery of arousal after CA deserves further investigation.

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“…Based on animal studies and isolated human case reports, electrical function of the brain ceases within 20 s after circulatory arrest. [18][19][20][21] The forum literature review could not identify any evidence base for either Menikoff's arguments or the IOM position.…”

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confidence: 99%

Donation after cardiocirculatory death in Canada

Shemie¹,

Baker²,

Knoll³

et al. 2006

Canadian Medical Association Journal

210

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Electroencephalographic Monitoring of Cerebral Function During Asystole and Successful Cardiopulmonary Resuscitation

Cited by 47 publications

References 0 publications

The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion

The use of bispectral index during a cardiopulmonary arrest: a potential predictor of cerebral perfusion

Intraventricular orexin-A improves arousal and early EEG entropy in rats after cardiac arrest

Donation after cardiocirculatory death in Canada

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