Prognostic Value of Electroencephalography in Cardiac Surgery

Hansotia, Phiroze; Myers, Wayne L.; Ray, Jefferson F.; Greehling, Clark; Sautter, Richard D.

doi:10.1016/s0003-4975(10)63994-x

Cited by 20 publications

(12 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4). This would seem to be due to the positive correlation between perfusion time and clinical complications established in a number of previous investigations 7 …”

Section: Discussionmentioning

confidence: 88%

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Sotaniemi¹,

Mononen²,

Hokkanen³

1986

Stroke

189

View full text Add to dashboard Cite

SUMMARY A prospective 5 years' neuropsychological, neurological, cardiological and electroencephalographkal follow-up study was carried out in 44 patients who had undergone open-heart surgery for valve replacement. A distinct interrelationship was found between the clinical outcome immediately after operation and the neuropsychological long-term course despite the rapid recovery of occasional clinical disorders related to operative procedures. In fact, the psychometric performance scores of those who did not develop clinical signs of cerebral dysfunction induced in operation showed a significant difference only years after operation. Similarly, the harmful effects of long perfusion time (ertracorporeal circulation) in operation were reflected in the long-term neuropsychological performance. Some evidence seemed to suggest that the correction of the prolonged circulatory disorder might possibly afford real enhancement of higher cerebral functions. The long-term results not only emphasize the importance of a careful clinical evaluation but also emphasize the necessity of considering the subclinteal level of events both before and after operation when assessing the overall outcome and cerebral safety of cardiac surgery patients.Stroke Vol 17, No 3, 1986CENTRAL NERVOUS SYSTEM (CNS) dysfunction has occasionally cast a shadow over the results of cardiac surgery. The development of surgical and anaesthesiological equipment has notably improved cerebral safety, and the occurrence of severe complications has become rare.'" 4 The well-being of the CNS, however, has not become self-evident and secure because several potentially harmful factors always remain in such complicated procedures as open-heart operations. It must also be emphasized that when only clinical criteria have been used to evaluate the CNS outcome, the appraisal of the results seems to have been too optimistic. 43 Clinical measures have been shown to provide only a narrow view over the actual CNS events, for the involvement of the subclinical levels has been revealed in electroencephalographical (EEG), 6 " 10 neuropsychological,"" 18 psychiatric 19 and radiological 20 studies.Previous studies investigating the long-term outcome of open-heart operations have concentrated their attention on cardiological and surgical aspects. "29 By contrast, the outcome of the higher cerebral functions has been given little attention, the earlier investigations having focused on describing the prevalence, nature and determinants of immediate postoperative disturbances using follow-up times limited to a few weeks or months."' l3 ' 16 Frank et al 16 performed a 6 months' study after operation and reported improvement in all the measured areas of intellectual performance. Preoperative anxiety seemed to worsen the improvement, probably by rendering the patients less apt to recall the test items. The intellectual changes were independent of cardiac functional measures. It was concluded that the observed improvement was only due to practice effects and that improved cerebral perf...

show abstract

“…4). This would seem to be due to the positive correlation between perfusion time and clinical complications established in a number of previous investigations 7 …”

Section: Discussionmentioning

confidence: 88%

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Sotaniemi¹,

Mononen²,

Hokkanen³

1986

Stroke

189

View full text Add to dashboard Cite

show abstract

“…The median total histopathological score was 13 (8)(9)(10)(11)(12)(13)(14)(15)(16). The cortex had a median histopathological score of 4, the hippocampus, cerebellum and brainstem of 2, and the thalamus of 1.…”

Section: Resultsmentioning

confidence: 99%

“…In this regard, EEG has been shown to be a valuable tool in neuromonitoring of patients undergoing cardiac surgery, and intraoperative and postoperative EEG deficits have been shown to be associated with clinically relevant cerebral dysfunction (6)(7)(8)(9). There is also some evidence showing that cerebral dysfunction as detected by EEG after experimental HCA is related to the duration of circulatory arrest, and that, in turn, these are associated with postoperative neurological complications (10).…”

Section: Discussionmentioning

confidence: 99%

EEG burst recovery is predictive of brain injury after experimental hypothermic circulatory arrest

Pokela

Jäntti

Lepola

et al. 2003

Scandinavian Cardiovascular Journal

View full text Add to dashboard Cite

show abstract

“…1969, T u f o et al 1970, Aberg & Kihlgren 1974, the presence of previous neurological diseases ( Branthwaite 1972), advanced cardiac dysfunction (Aberg & Kihlgren 1974, Kilpatrick et al 1975) and some psychometric correlates (low scores in the trail making test) ( Kilpatrick et al 1975, Willner et al 1976) have been mentioned as prognostically disadvantageous. On the other hand, EEG has been claimed to have no predictive r61e ( Lorenz & Hehrlein 1970, Hansotia et al 1975. Thus generally, it has been thought that the possibilities of indicating high risk cases with increased liability to dysfunction after ECC are scanty.…”

Section: Multidimensional Prediction Of the Outcomementioning

confidence: 99%

“…Since predictive information would offer one tool for these purposes, we found it appropriate to bring together the results obtained from our multidimensional follow-up study on open-heart surgery patients (Sotanierni 1980a, b, Sotaniemi et al 1980 with particular emphasis on the preoperative measures with possible prognostic value. These studies suggested some prognostically unfavourable conditions: presence of cerebrovascular accidents or syncope in case histories; slow or sharp wave electroencephalographical (EEG) disturbances; low dominant EEG frequency in quantitative EEG analysis; and certain neuropsychological distur- Branthwaite 1972, 1975, Hansotia et al 1975, Kilpatrick et al 1975, Willner et al 1976 have approached the prognosis from purely clinical, EEG or neuropsychological angles, this study was designed in order to elucidate all these aspects simultaneously, to allow an overall assessment of the different cerebral functional levels.…”

mentioning

confidence: 99%

Prediction of cerebral outcome after extracorporeal circulation

Sotaniemi

1982

Acta Neurologica Scandinavica

View full text Add to dashboard Cite

50 open-heart patients were investigated using simultaneous clinical, electroencephalographical (EEG) and neuropsychological evaluation in order to assess the possibilities of predicting the postoperative outcome with preoperative measures. The presence of one or more of the following indices was prognostically unfavourable: a history of cerebrovascular diseases or syncope; delta or sharp wave EEG abnormalities or low quantitative EEG mean frequency; a poor performance score in one of the psychometric tests (colour naming). Using these measures, 28 cases with presumably high risks were indicated, and 24 (86%) sustained cerebral complications attributable to the operation. The observations contrast clearly with previous studies whose predictions, using only one single criterion, have proved invalid. A significant level of prediction seems to be obtainable, but only by the simultaneous consideration of several different cerebral functions. The prognostic approach may offer one way of achieving the necessarily needed improved cerebral safety in cardiac surgery.

show abstract

Prognostic Value of Electroencephalography in Cardiac Surgery

Cited by 20 publications

References 8 publications

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study.

EEG burst recovery is predictive of brain injury after experimental hypothermic circulatory arrest

Prediction of cerebral outcome after extracorporeal circulation

Contact Info

Product

Resources

About