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SHR Neuro Cancer Cardio Lipid Metab Microb
Dahaba, AA; Xue, JX; Hua, Y; Liu, QH; Xu, GX; Liu, YM; Meng, XF; Zhao, GG; Rehak, PH; Metzler, H.
The utility of using the bispectral index-Vista for detecting cross-clamping decline in cerebral blood flow velocity.
Neurosurgery. 2010; 67(3 Suppl Operative): 102-107.
Doi: 10.1227/01.NEU.0000383152.50183.81
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Metzler Helfried
- Rehak Peter
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- Abstract:
- BACKGROUND: Patients undergoing carotid endarterectomy for extracranial internal carotid artery stenosis are at risk of cerebral ischemia/hypoperfusion. Criterion recommended by European and American committees to determine whether to place a shunt consisted of a decline in transcranial Doppler ultrasonography-measured middle cerebral artery blood flow velocity (MCBFV) to < 30% to 40% of intraoperative preclamp value. OBJECTIVE:To assess the discriminative power of the bispectral index (BIS)-Vista monitor for detecting a 40% decline in MCBFV with cross-clamping. METHODS: In 20 patients undergoing carotid endarterectomy under remifentanil/propofol anesthesia, BIS-Vista data, MCBFV, and pulsatility index from bilaterally mounted BIS-Vista and transcranial Doppler monitors were continuously recorded. RESULTS: Coefficient of determination revealed good correlation (r(2) = 0.763) between ipsilateral BIS-Vista and MCBFV after cross-clamping. BIS-Vista exhibited a high discriminative power of 0.850(95% confidence interval, 0.455-0.966) area under the receiver-operating characteristic curve in detecting an ipsilateral 40% MCBFV decline. Two-way analysis of variance (location by time) suggests that BIS-Vista exhibited a global decline; ie, both BIS-Vistas declined when 1 carotid on either side was clamped because there was no significant interhemispheric difference (P = .112) in mean BIS-Vista values over time. CONCLUSION: Although we demonstrated good correlation and high discriminative power of the BIS-Vista monitor in depicting a MCBFV decline that could serve as indicator of decline in cerebral activity, BIS-Vista cannot be considered a reliable indicator of cerebral ischemia/hypoperfusion that could replace transcranial Doppler monitoring to determine whether a shunt is to be placed.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Algorithms -
- Blood Circulation Time - methods
- Blood Flow Velocity - physiology
- Carotid Stenosis - physiopathology
- Cerebrovascular Circulation - physiology
- Electroencephalography - methods
- Electromyography -
- Endarterectomy, Carotid - methods
- Female -
- Functional Laterality - physiology
- Humans -
- Male -
- Middle Aged -
- Middle Cerebral Artery - physiopathology
- Monitoring, Intraoperative - methods
- ROC Curve -
- Ultrasonography, Doppler, Transcranial - methods
- Find related publications in this database (Keywords)
- Bispectral Index
- Carotid endarterectomy
- Electroencephalography
- Transcranial Doppler ultrasonography