Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Dong-Kyu Lee¹  Laurence Weinberg²  Glenn M. Eastwood³  Fumitaka Yanase⁴  Rinaldo Bellomo⁵  Alessandro Belletti⁶  Thummaporn Naorungroj⁷ 

[1] Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea;Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia;Department of Anaesthesia, Austin Hospital, Heidelberg, VIC, Australia;Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia;Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia;Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia;Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia;Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia;Department of Critical Care, The University of Melbourne, Melbourne, VIC, Australia;Data Analytics Research and Evaluation Centre, The University of Melbourne and The Austin Hospital, Melbourne, VIC, Australia;Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia;Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy;Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia;Department of Intensive Care, Siriraj Hospital, Mahidol University, Bangkok, Thailand;

关键词: anesthesia;    electroencephalography;    cardiac surgery;    neuromonitoring;    neuroprotection;    propofol;    delirium;    cardiopulmonary bypass;   

DOI  :  10.3389/fcvm.2023.1084426

 received in 2022-10-30, accepted in 2023-06-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveProcessed electroencephalography (pEEG) is used to monitor depth-of-anesthesia during cardiopulmonary bypass (CPB). The SedLine device has been recently introduced for pEEG monitoring. However, the effect of hypothermia on its parameters during CPB is unknown. Accordingly, we aimed to investigate temperature-induced changes in SedLine-derived pEEG parameters during CPB.DesignProspective observational study.SettingCardiac surgery operating theatre.Participants28 patients undergoing elective cardiac surgery with CPB.InterventionsWe continuously measured patient state index (PSI), suppression ratio (SR), bilateral spectral edge frequency (SEF) and temperature. We used linear mixed modelling with fixed and random effects to study the interactions between pEEG parameters and core temperature.Measurements and main resultsDuring CPB maintenance, the median temperature was 32.1°C [interquartile range (IQR): 29.8–33.6] at the end of cooling and 32.8°C (IQR: 30.1–34.0) at rewarming initiation. For each degree Celsius change in temperature during cooling and rewarming the PSI either decreased by 0.8 points [95% confidence interval (CI): 0.7–1.0; p < 0.001] or increased by 0.7 points (95% CI: 0.6–0.8; p < 0.001). The SR increased by 2.9 (95% CI: 2.3–3.4); p < 0.001) during cooling and decreased by 2.2 (95% CI: 1.7–2.7; p < 0.001) during rewarming. Changes in the SEF were not related to changes in temperature.ConclusionsDuring hypothermic CPB, temperature changes led to concordant changes in the PSI. The SR increased during cooling and decreased during rewarming. Clinicians using SedLine for depth-of-anesthesia monitoring should be aware of these effects when interpreting the PSI and SR values.

【 授权许可】

Unknown   
© 2023 Belletti, Lee, Yanase, Naorungroj, Eastwood, Bellomo and Weinberg.