Measuring the Performance of Anesthetic Depth Indicators

Wd, Smith; Rc, Dutton; Nt, Smith

doi:10.1097/00000542-199601000-00005

Cited by 393 publications

(293 citation statements)

References 45 publications

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“…8 Our post hoc analysis also evaluated the impact of ß-blockade on the performance of routine anesthetic depth indicators using the previously established model of prediction probability P K . 3 The results of these analyses indicate that routinely used hemodynamic variables do not reliably predict BIS, regardless of the presence or absence of ß-blockade. Poor prediction of the hypnotic state by hemodynamic variables was recently reported by Struys et al 9 Interestingly, we observed a better performance of HR to predict BIS in the presence of higher doses of atenolol.…”

Section: Performance Of Routine Anesthetic Depth Indicatorsmentioning

confidence: 92%

“…Specifically, we examined the effects of atenolol on the performance of the routinely used anesthetic depth indicators, i.e., heart rate (HR), blood pressure (BP), and end-tidal anesthetic gas concentrations to predict depth of anesthesia, as indicated by the bispectral index (BIS), using a previously described statistical model. 3 …”

Section: Me Et Th Ho Od Ds S:mentioning

confidence: 99%

“…The performance to predict BIS was calculated for HR, MAP, SAP, their absolute fractional changes between two consecutive two-minute epochs, and end-tidal isoflurane concentration using the previously described statistical model of prediction probability (P K ). 3 Calculations for P K were performed with a custom spreadsheet macro PKMACRO (Prof. W.D. Smith, Sate University, Sacramento, CA, USA) using Excel (Microsoft Corporation, Redmond, WA, USA).…”

Section: Assessing the Performance Of Routine Anesthetic Depth Indicamentioning

confidence: 99%

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L’aténolol ne modifierait pas les indicateurs de la profondeur de l’anesthésie chez les patients âgés — un réexamen des données

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Section: Performance Of Routine Anesthetic Depth Indicatorsmentioning

confidence: 92%

Section: Me Et Th Ho Od Ds S:mentioning

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Section: Assessing the Performance Of Routine Anesthetic Depth Indicamentioning

confidence: 99%

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L’aténolol ne modifierait pas les indicateurs de la profondeur de l’anesthésie chez les patients âgés — un réexamen des données

Zaugg

Tagliente

Silverstein

et al. 2003

Can J Anesth/J Can Anesth

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“…Even implicit learning initially requires consciousness of stimuli from which regularities are unconsciously developed. 12 Conscious scenes have an allocentric character. They show intentionality, yet are shaped by egocentric frameworks.…”

Section: It Is Calculated As Mi(a;b) ϭ H(a) ϩ H(b) ϫ H(ab)mentioning

confidence: 99%

“…The ability to assess quantifiable aspects of consciousness at the neural level without first-person report would be useful for the assessment of depth of anesthesia (12) as well as in the analysis of various neurological and psychiatric disorders (13). Application of quantitative measures may also contribute to comparative studies of consciousness.…”

mentioning

confidence: 99%

Theories and measures of consciousness: An extended framework

Seth

Izhikevich

Reeke

et al. 2006

Proc. Natl. Acad. Sci. U.S.A.

223

214

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A recent theoretical emphasis on complex interactions within neural systems underlying consciousness has been accompanied by proposals for the quantitative characterization of these interactions. In this article, we distinguish key aspects of consciousness that are amenable to quantitative measurement from those that are not. We carry out a formal analysis of the strengths and limitations of three quantitative measures of dynamical complexity in the neural systems underlying consciousness: neural complexity, information integration, and causal density. We find that no single measure fully captures the multidimensional complexity of these systems, and all of these measures have practical limitations. Our analysis suggests guidelines for the specification of alternative measures which, in combination, may improve the quantitative characterization of conscious neural systems. Given that some aspects of consciousness are likely to resist quantification altogether, we conclude that a satisfactory theory is likely to be one that combines both qualitative and quantitative elements.complexity ͉ differentiation ͉ dynamic core ͉ integration

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Frontal electroencephalogram variables are associated with the outcome and stage of hepatic encephalopathy in acute liver failure

et al. 2014

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Acute liver failure (ALF) and hepatic encephalopathy (HE) can lead to an elevated intracranial pressure (ICP) and death within days. The impaired liver function increases the risks of invasive ICP monitoring, whereas noninvasive methods remain inadequate. The purpose of our study was to explore reliable noninvasive methods of neuromonitoring for patients with ALF in the intensive care unit (ICU) setting; more specifically, we wanted to track changes in HE and predict the outcomes of ALF patients treated with albumin dialysis. The study included 20 patients with severe ALF at admission who had been referred to the ICU of the liver transplantation (LT) center for albumin dialysis treatment and evaluation for transplantation. Data were collected from all study patients in the form of continuous frontal electroencephalography (EEG) recordings and transcranial Doppler (TCD) measurements of cerebral blood flow. Among the studied EEG variables, the 50% spectral edge frequency decreased and the delta power increased as the HE stage increased. Both variables were predictive of the stage of HE [prediction probability (P K ) of 50% spectral edge frequency 5 0.23, standard error (SE) 5 0.03; P K of delta power 5 0.76, SE 5 0.03]. The total wavelet subband entropy, a novel variable that we used for tracking abnormal EEG activity, predicted the outcome of ALF patients treated with albumin dialysis (P K 5 0.88, SE 5 0.09). With a threshold value of 1.6, the TCD pulsatility index had an odds ratio of 1.1 (95% confidence interval 5 0.1-9.3) for a poor outcome (LT or death). In conclusion, EEG variables are useful for the monitoring of HE and can be used to predict outcomes of ALF. TCD measurements do not predict patient outcomes.

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Measuring the Performance of Anesthetic Depth Indicators

Abstract: Prediction probability PK is an appropriate measure for evaluating and comparing the performance of anesthetic depth indicators.

Cited by 393 publications

References 45 publications

L’aténolol ne modifierait pas les indicateurs de la profondeur de l’anesthésie chez les patients âgés — un réexamen des données

L’aténolol ne modifierait pas les indicateurs de la profondeur de l’anesthésie chez les patients âgés — un réexamen des données

Theories and measures of consciousness: An extended framework

Frontal electroencephalogram variables are associated with the outcome and stage of hepatic encephalopathy in acute liver failure

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