Noninvasive Neuromonitoring of Hypothermic Circulatory Arrest in Aortic Surgery

Show full item record



Stewart , J A , Särkelä , M O K , Salmi , T , Wennervirta , J , Vakkuri , A P , Vainikka , T L S , Suojaranta , R , Mäki , K , Ilkka , V H , Viertiö-Oja , H & Salminen , U-S 2020 , ' Noninvasive Neuromonitoring of Hypothermic Circulatory Arrest in Aortic Surgery ' , Scandinavian Journal of Surgery , vol. 109 , no. 4 , pp. 320-327 .

Title: Noninvasive Neuromonitoring of Hypothermic Circulatory Arrest in Aortic Surgery
Author: Stewart, J. A.; Särkelä, M. O. K.; Salmi, T.; Wennervirta, J.; Vakkuri, A. P.; Vainikka, T. L. S.; Suojaranta, R.; Mäki, K.; Ilkka, V. H.; Viertiö-Oja, H.; Salminen, U-S
Contributor organization: Kardiologian yksikkö
HUS Heart and Lung Center
University of Helsinki
HUS Medical Imaging Center
Kliinisen neurofysiologian yksikkö
Department of Neurosciences
Department of Diagnostics and Therapeutics
Anestesiologian yksikkö
HUS Perioperative, Intensive Care and Pain Medicine
III kirurgian klinikka
Department of Surgery
Date: 2020-12
Language: eng
Number of pages: 8
Belongs to series: Scandinavian Journal of Surgery
ISSN: 1457-4969
Abstract: Background and Aims: Circulatory arrest carries a high risk of neurological damage, but modern monitoring methods lack reliability, and is susceptible to the generalized effects of both anesthesia and hypothermia. The objective of this prospective, explorative study was to research promising, reliable, and noninvasive methods of neuromonitoring, capable of predicting neurological outcome after hypothermic circulatory arrest. Materials and Methods: Thirty patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta were recruited in a single center and over the course of 4 years. Neuromonitoring was performed with a four-channel electroencephalogram montage and a near-infrared spectroscopy monitor. All data were tested off-line against primary neurological outcome, which was poor if the patient suffered a significant neurological complication (stroke, operative death). Results: A poor primary neurological outcome seen in 10 (33%) patients. A majority (63%) of the cases were emergency surgery, and thus, no neurological baseline evaluation was possible. The frontal hemispheric asymmetry of electroencephalogram, as measured by the brain symmetry index, predicted primary neurological outcome with a sensitivity of 79 (interquartile range; 62%-88%) and specificity of 71 (interquartile range; 61%-84%) during the first 6 h after end of circulatory arrest. Conclusion: The hemispheric asymmetry of frontal electroencephalogram is inherently resistant to generalized dampening effects and is predictive of primary neurological outcome. The brain symmetry index provides an easy-to-use, noninvasive neuromonitoring method for surgery of the thoracic aorta and postoperative intensive care.
Subject: Brain symmetry index
circulatory arrest
near-infrared spectroscopy
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

Files in this item

Total number of downloads: Loading...

Files Size Format View
1457496919863942.pdf 513.0Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record