Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass
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 inves...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1084426/full |
| _version_ | 1797788217451216896 |
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| author | Alessandro Belletti Alessandro Belletti Dong-Kyu Lee Fumitaka Yanase Fumitaka Yanase Thummaporn Naorungroj Thummaporn Naorungroj Glenn M. Eastwood Rinaldo Bellomo Rinaldo Bellomo Rinaldo Bellomo Rinaldo Bellomo Laurence Weinberg Laurence Weinberg |
| author_facet | Alessandro Belletti Alessandro Belletti Dong-Kyu Lee Fumitaka Yanase Fumitaka Yanase Thummaporn Naorungroj Thummaporn Naorungroj Glenn M. Eastwood Rinaldo Bellomo Rinaldo Bellomo Rinaldo Bellomo Rinaldo Bellomo Laurence Weinberg Laurence Weinberg |
| author_sort | Alessandro Belletti |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-13T01:33:25Z |
| format | Article |
| id | doaj.art-ddd0c7ddc7be4c1aa2828f71b83961ab |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-13T01:33:25Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-ddd0c7ddc7be4c1aa2828f71b83961ab2023-07-04T06:26:48ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-07-011010.3389/fcvm.2023.10844261084426Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypassAlessandro Belletti0Alessandro Belletti1Dong-Kyu Lee2Fumitaka Yanase3Fumitaka Yanase4Thummaporn Naorungroj5Thummaporn Naorungroj6Glenn M. Eastwood7Rinaldo Bellomo8Rinaldo Bellomo9Rinaldo Bellomo10Rinaldo Bellomo11Laurence Weinberg12Laurence Weinberg13Department of Intensive Care, Austin Hospital, Heidelberg, VIC, AustraliaDepartment of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, ItalyDepartment of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of KoreaDepartment of Intensive Care, Austin Hospital, Heidelberg, VIC, AustraliaAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, AustraliaDepartment of Intensive Care, Austin Hospital, Heidelberg, VIC, AustraliaDepartment of Intensive Care, Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Intensive Care, Austin Hospital, Heidelberg, VIC, AustraliaDepartment of Intensive Care, Austin Hospital, Heidelberg, VIC, AustraliaAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, AustraliaDepartment of Critical Care, The University of Melbourne, Melbourne, VIC, AustraliaData Analytics Research and Evaluation Centre, The University of Melbourne and The Austin Hospital, Melbourne, VIC, AustraliaDepartment of Critical Care, The University of Melbourne, Melbourne, VIC, AustraliaDepartment of Anaesthesia, Austin Hospital, Heidelberg, VIC, AustraliaObjectiveProcessed 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.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1084426/fullanesthesiaelectroencephalographycardiac surgeryneuromonitoringneuroprotectionpropofol |
| spellingShingle | Alessandro Belletti Alessandro Belletti Dong-Kyu Lee Fumitaka Yanase Fumitaka Yanase Thummaporn Naorungroj Thummaporn Naorungroj Glenn M. Eastwood Rinaldo Bellomo Rinaldo Bellomo Rinaldo Bellomo Rinaldo Bellomo Laurence Weinberg Laurence Weinberg Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass Frontiers in Cardiovascular Medicine anesthesia electroencephalography cardiac surgery neuromonitoring neuroprotection propofol |
| title | Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass |
| title_full | Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass |
| title_fullStr | Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass |
| title_full_unstemmed | Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass |
| title_short | Changes in SedLine-derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass |
| title_sort | changes in sedline derived processed electroencephalographic parameters during hypothermia in patients undergoing cardiac surgery with cardiopulmonary bypass |
| topic | anesthesia electroencephalography cardiac surgery neuromonitoring neuroprotection propofol |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1084426/full |
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