Hypothermia Plus Thiopental: Prolonged Electroencephalographic Suppression

Quasha, Arthur L.; Tinker, John H.; Sharbrough, F. W.

doi:10.1097/00132586-198210000-00017

Cited by 2 publications

(2 citation statements)

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“…Indeed, most processed EEG depth of anaesthesia monitor devices recognise BS as one of the parameters to display with the presence of BS recognised as a definition for deep anaesthesia. BS has also been demonstrated in coma [75], hypoxic brain injury following cardiac arrest [76], drug intoxication, encephalopathies [77] and hypothermia [78]. Specific patterns of BS with generalised bursts with stereotypical morphology have been associated with poor outcome in comatose patients after cardiac arrest [79].…”

Section: Burst-suppressionmentioning

confidence: 99%

A pragmatic approach to intravenous anaesthetics and electroencephalographic endpoints for the treatment of refractory and super-refractory status epilepticus in critical care

Prisco

Ganau

Aurangzeb

et al. 2020

Seizure

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Status epilepticus is a common neurological emergency, with overall mortality around 20%. Over half of cases are first time presentations of seizures. The pathological process by which spontaneous seizures are generated arises from an imbalance in excitatory and inhibitory neuronal networks, which if unchecked, can result in alterations in intracellular signalling pathways and electrolyte shifts, which bring about changes in the blood brain barrier, neuronal cell death and eventually cerebral atrophy. This narrative review focusses on the treatment of status epilepticus in adults. Anaesthetic agents interrupt neuronal activity by enhancing inhibitory or decreasing excitatory transmission, primarily via GABA and NMDA receptors. Intravenous anaesthetic agents are commonly used as second or third line drugs in the treatment of refractory status epilepticus, but the optimal timing and choice of anaesthetic drug has not yet been established by high quality evidence. Titration of antiepileptic and anaesthetic drugs in critically ill patients presents a particular challenge, due to alterations in drug absorbtion and metabolism as well as changes in drug distrubution, which arise from fluid shifts and altered protein binding. Furthermore, side effects associated with prolonged infusions of anaesthetic drugs can lead to multi-organ dysfunction and a need for critical care support. Electroencelography can identify patterns of burst suppression, which may be a target to guide weaning of intravenous therapy. Continuous elctroencephalography has the potential to directly impact clinical care, but despite its utility, major barriers exist which have limited its widespread use in clinical practice. A flow chart outlining the timing and dosage of anaesthetic agents used at our institution is provided.

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Section: Burst-suppressionmentioning

confidence: 99%

A pragmatic approach to intravenous anaesthetics and electroencephalographic endpoints for the treatment of refractory and super-refractory status epilepticus in critical care

Prisco

Ganau

Aurangzeb

et al. 2020

Seizure

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show abstract

“…Concomitantly, however, these patients had depressed myocardial contractility and required longer pulmonary recovery periods for extubation (29). It is not known whether barbituates and hypothermia have an additive effect on cephaloplegia, but profound cerebral depressant effects are seen during CPB with thiopental doses of 8 to 24 mgfkg• 1 at 25 to 30°C hypothermia (30). We have utilized a dose of 12.5 mg!kg• 1 of thiamylal in all patients undergoing CA or BP.…”

Section: Cardiopulmonary Bypassmentioning

confidence: 99%

Extracorporeal Circulation During Treatment of Aneurysms of the Ascending Aorta

Stammers,

Butler,

Kirsh

1990

J Extra Corpor Technol

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Extracorporeal circulation in the treatment of aneurysms of the ascending aorta and transverse arch present both the surgeon and perfusionist with a formidable challenge. Thirty-one patients presented with either of these anomalies and have been treated in a two-year period from August 1987 to December 1989 at the University of Michigan. Of these, 11 had lesions which involved one or more arch vessels and necessitated either a period of circulatory arrest (7 patients) or brachiocephalic perfusion (four patients). Mean circulatory arrest periods were 44.8 ± 9.0 minutes (Mean ± SD), while the brachiocephalic perfusion patients had one or more arch vessels cannulated for a mean length of 64.3 ± 19.7 minutes. Postoperative complications in both groups included pulmonary and renal insufficiency, coagulopathies, and neurological deficits. The circulatory arrest group experienced encephalopathies (5/7 patients) and high perioperative mortality (4/7 patients). In the brachiocephalic perfusion group only one patient experienced postoperative neurological complications and there were no immediate postoperative deaths. Lesions of the ascending and transverse aorta are often associated with high morbidity and mortality. Although these population groups are small we believe that the technique of cerebral perfusion via cannulation of the brachiocephalic vessels provides a safe alternative to that of hypothermic circulatory arrest.

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Hypothermia Plus Thiopental: Prolonged Electroencephalographic Suppression

Cited by 2 publications

References 0 publications

A pragmatic approach to intravenous anaesthetics and electroencephalographic endpoints for the treatment of refractory and super-refractory status epilepticus in critical care

A pragmatic approach to intravenous anaesthetics and electroencephalographic endpoints for the treatment of refractory and super-refractory status epilepticus in critical care

Extracorporeal Circulation During Treatment of Aneurysms of the Ascending Aorta

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