SavedAdd your journal

Journals / Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi / 2016 / Cilt: 22 - Sayı: 2

Simultaneous Monitoring of Quantitative EEG and Cerebral Oxygenation in Heart Transplantation

Kalp Transplantasyonunda Kantitatif EEG ve Serebral Oksijenasyonun Birlikte Monitörizasyonu

Mustafa PAÇ
Pages
50–54
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Multimodal neuromonitorization can be a lodestar for anaesthetic induction, resternotomies, cannulation, se?rious arrhythmias, hypotensive attacks due to medicati?ons used, embolic events due to intracardiac thrombi and sudden development of dysfunction in the donor heart in these patients with borderline ventricular function.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: In this article, we discuss intraoperative changes of EEG, SEF, PSI values measured by Sed?Line® and bilateral cerebral oxymetry (rSO2 ) values measured by NIRS in heart transplantation, and their interrelationships.
📊
Key Findings & Data:Bila?teral SEF values, PSI values and bilateral rSO2 values were recorded before (phase 1), and 5 minutes (phase 2), after anaesthesic induction of anesthesia 5 minutes after establishing cardiopulmonary bypass (phase 3), 5 minutes after cross-clamping (phase 4), at 5. minute after weaning from cardiopulmonary bypass (phase 5), and at the end of the operation (phase 6).
💡
Conclusion & Impact:Multimodal neuromonitorization can be a lodestar for anaesthetic induction, resternotomies, cannulation, se?rious arrhythmias, hypotensive attacks due to medicati?ons used, embolic events due to intracardiac thrombi and sudden development of dysfunction in the donor heart in these patients with borderline ventricular function.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: In this article, we discuss intraoperative changes of EEG, SEF, PSI values measured by Sed?Line® and bilateral cerebral oxymetry (rSO2 ) values measured by NIRS in heart transplantation, and their interrelationships. Material and Methods: Thirteen adult patients who had undergone heart transplantation were included in our study. Demographic, and clinical data, intraope?rative hemodynamic values; cerebral monitorization and mortality data were collected prospectively. Bila?teral SEF values, PSI values and bilateral rSO2 values were recorded before (phase 1), and 5 minutes (phase 2), after anaesthesic induction of anesthesia 5 minutes after establishing cardiopulmonary bypass (phase 3), 5 minutes after cross-clamping (phase 4), at 5. minute after weaning from cardiopulmonary bypass (phase 5), and at the end of the operation (phase 6). Results: Mean age of the patients was 32.7±10.8 years. rSO2 and SEF values did not show any significant diffe?rence between right and left hemispheres. Preoperative SEF, PSI and rSO2 values declined significantly after induction of anesthesia and remained significantly lo?wer compared with the baseline measurement throug?hout the operation. Discussion and Conclusion: In this study, cerebral moni?toring values decreased significantly after induction due to the impact of anesthesia and remained low througho?ut the operation as expected. Any critical adverse event which required intervention did not occur. in these cases. Multimodal neuromonitorization can be a lodestar for anaesthetic induction, resternotomies, cannulation, se?rious arrhythmias, hypotensive attacks due to medicati?ons used, embolic events due to intracardiac thrombi and sudden development of dysfunction in the donor heart in these patients with borderline ventricular function.

Özet

Amaç: Bu makalede kalp transplantasyonu sırasında SedLine monitörü ile ölçülen EEG SEF, PSI değerleri ve NIRS ile ölçülen bilateral serebral oksimetre (rSO2) değerlerinin birbiriyle ilişkisini ve ameliyat süresince gözlenen değişimlerini tartıştık. Gereç ve Yöntem: Kalp nakli olmuş 13 erişkin hasta observasyonel çalışmamıza dâhil edildi. Demografikklinik data, intraoperatif hemodinamik, serebral monitörizasyon verileri, mortalite bilgileri prospektif olarak toplandı. Anestezi indüksiyonundan önce (1. dönem), indüksiyondan 5 dk. sonra (2. dönem), kardiyopulmoner baypasa girildikten 5 dk. sonra (3. dönem), kros klemp konduktan 5 dk. sonra (4. dönem), kardiyopulmoner baypas sonrası 5. dk.'da (5. dönem) ve ameliyatın sonunda (6. dönem) bilateral SEF değerleri, PSI değerleri ve bilateral rSO2 değerleri kaydedildi.Bulgular: Hastaların yaş ortalaması 32.7±10.8 bulundu. rSO2 ve SEF değerleri sağ ve sol arasında hiçbir dönemde farklı seyretmedi. Ameliyat öncesi yapılan SEF, PSI-rSO2 ölçümlerinin anestezi indüksiyonunu takiben anlamlı olarak düştüğü ve ameliyat boyunca ilk ölçüme göre anlamlı olarak düşük seyrettiği gözlendi. Tartışma ve Sonuç: Bu çalışmada, indüksiyon sonrası anesteziye bağlı olarak serebral değerlerin beklendiği üzere düştüğü ve ameliyat boyunca da benzer şekilde kaldığı gözlendi. Müdahale gerektirecek herhangi bir kritik olay olmadı ancak sınırda ventrikül fonksiyonu olan bu hastalarda anestezi indüksiyonu, revakalarda sternumun açılması, kanülasyon, ciddi aritmiler, kulla- nılan ilaçlara bağlı hipotansiyon atakları, intrakardi- yak trombüs ve buna bağlı emboliler, yeni kalpte gelişe- bilen ani disfonksiyon gibi birçok durumda multimodal nöromonitörizasyon yol gösterici olabilir.

🔖

Cite This Article

PAÇ, M. (2016). Simultaneous Monitoring of Quantitative EEG and Cerebral Oxygenation in Heart Transplantation. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, Cilt: 22 - Sayı: 2, 50–54. https://ajindex.com/articles/178119

References (11)

  1. Eltzschig HK, Zwissler B, Felbinger TW. Perioperative implications of heart transplantation. Anaesthesist 2003;52:678-89.
  2. DiNardo JA, Zvara DA. Heart, heart-lung and lung transplantation. In: Anesthesia for Cardiac Surgery. (DiNardo JA, Zvara DA, eds)3.baskı, Blackwell Publishing, Massachusetts 2008;252-88
  3. Rubio A, Hakami L, Münch F, Tandler R, Harig F,Weyand M. Non invasive control of adequate cerebral oxygenation during low-flow antegrat selective cerebral perfusion on adults and infants in the aortic arch surgery. J Card Surg 2008;23:474-9.
  4. Yiğit T, Karadeniz Ü, Erdemli Ö, Demir A, Küçüker Ş. Yüksek riskli arkus aort anevrizma ameliyatında üçlü serebral monitörizasyon. GKDA Derg 2011;17(2):42- 48
  5. Park KS, Hur EJ, Han KW, Kil HY, Han TH. Bispectral index does not correlate with observer assessment of alertness and sedation scores during 0.5% bupivacaine epidural anesthesia with nitrous oxide sedation. Anesth Analg 2006;103(2):385-9.
  6. Duarte LT, Saraiva RA. When the bispectral index (bis) can give false results. Rev Bras Anestesiol 2009;59(1):99-109.
  7. Aydınlı B, Demir A, Savcı Y, Uçar P, İrdem AK, Ulus AT, et al. Karotis endarterektomilerde intraoperatif 4 kanallı eeg monitörizasyonu ve postoperatif nörolojik prognoz. Anestezi Dergisi 2014;22(2):74-8
  8. Demir A, Aydınlı B, Ünal EU, Bindal M, Koçulu R, Sarıtaş A, et al. Aort cerrahisinde intraoperatif 16 kanallı elektroensefalografi ve bilateral near infrared spektroskopi monitörizasyonu. Turk J Anaesth Reanim 2015;43:274-8.
  9. Ellis L, Murphy GJ, Culliford L, Dreyer L, Clayton G, Downes R, et al. The effect of patient-specific cerebral oxygenation monitoring on postoperative cognitive function: A multicenter randomized controlled Trial. JMIR Res Protoc 2015;4(4):e137.
  10. Shoushtarian M, McGlade DP, Delacretaz LJ, Liley DT. Evaluation of the brain anaesthesia response monitor during anaesthesia for cardiac surgery: a doubleblind, randomised controlled trial using two doses of fentanyl. J Clin Monit Comput 2015, Sep 25.
  11. Zierer A, Melby SJ, Voeller RK, Guthrie TJ, AlDadah AS, Meyers BF, et al. Significance of neurologic complications in the modern era of cardiac tr