Detection of cerebral hypoperfusion with bispectral index during paediatric cardiac surgery

Hayashida, Masakazu; Chinzei, Mieko; Komatsu, Kyoko; Yamamoto, Hiroshi; Tamai, Hisayoshi; Orii, Ryo; Hanaoka, Kazuo; Murakami, Arata

doi:10.1093/bja/aeg107

Cited by 79 publications

(60 citation statements)

References 11 publications

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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. It has also been advocated as an anaesthesia monitor in cardiac surgery [8], where neurological complications are of concern, a fact that further increases the appreciation of this relationship due to the higher risk of cardiovascular complications in this type of surgery.…”

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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“…Hayashida et al 11 observed acute EEG slowing and BIS reduction in a patient at the start of cardiopulmonary bypass. They attributed the observation to cerebral hypoperfusion due to reduced arterial pressure and hemodilution.…”

Section: Discussionmentioning

confidence: 98%

Modification de l’index bispectral suite à une embolisation avec alcool absolu chez un patient souffrant de malformation artérioveineuse intracrânienne

Unnikrishnan

Sinha

Sriganesh

et al. 2007

Can J Anesth/J Can Anesth

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Purpose:We report a case of bispectral index (BIS) falling to zero during absolute alcohol embolization of an intracranial arteriovenous malformation (AVM) under anesthesia. This case highlights the unusual effect of a therapeutic dose of parenteral alcohol on the central nervous system using BIS monitoring. Clinical features:A 29-yr-old male with a left parieto-occipital arteriovenous malformation underwent neuroendovascular embolization under general anesthesia. During injection of absolute alcohol injection into the AVM nidus, the patient developed hypertension and tachycardia coincident with a profound and sustained reduction of BIS values to zero, despite a stable level of anesthesia. Immediate angiography revealed no evidence of hemorrhage or new changes in the patient's cerebral vasculature. Post-procedure, the patient remained drowsy for several hours with signs of alcohol intoxication. He had full neurological recovery. Conclusions:In the presence of normal cerebral angiographic findings, suppression of BIS values may serve as an early indicator of CNS responses to intracranial injection of absolute alcohol for embolization of an arteriovenous malformation.

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“…A study done in children undergoing CPB documented the drop in BiS value at onset of CPB, though this study correlated all episodes of cerebral hypoperfusion and concluded that reduction in BiS value correlated with cerebral hypoperfusion [5]. Thomas et al [6] studied BiS in patients undergoing off pump coronary artery surgery (OPCAB) and found that the incidence of hypotension correlated with low values of BiS and proposed that BiS might be used as an indicator of cerebral hypoperfusion in OPCAB.…”

Section: Discussionmentioning

confidence: 99%

Changes in BiSpecteral Index (BiS) Values During Cardiopulmonary Bypass (CPB)

Sinha

Ramesh

Singh³

2011

Medical Journal Armed Forces India

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Background: BiSpecteral Index (BiS) monitoring is standard monitoring regimen in anaesthesia practice. It has also been used in cardiac surgery. It is especially important due to the high incidence 01 neurological injury or dysfunction that occurs following CPB. This is a retrospective stody of 33 cases that were monitored with BiS during the course of coronary artery or valvular surgery, including the period 01 CPB. Methods: Thirty three cases monitored with BiS were studied retrospectively. Result: From the recordings it was determined that the value of BiS which was ranging between 40 to 60 oller induction, dropped below 25 at the onset of CPB. This change was statistically significant (p<0.05). Conclusion: This decrease in the BiS value is probably a result of hypo-perfusion and due to clear, oxygen -poor priming flnid reaching the brnin. Other periods 01 hypotension also correlated with the low values of BiS. This cerebral hypoxia which would

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Detection of cerebral hypoperfusion with bispectral index during paediatric cardiac surgery

Abstract: Our findings suggest that an acute decrease in BIS during acute hypotension indicates cerebral hypoperfusion, and that cerebral hypoperfusion caused by hypotension may occur frequently during paediatric cardiac surgery.

Cited by 79 publications

References 11 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

Modification de l’index bispectral suite à une embolisation avec alcool absolu chez un patient souffrant de malformation artérioveineuse intracrânienne

Changes in BiSpecteral Index (BiS) Values During Cardiopulmonary Bypass (CPB)

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