| Cerebral Ischemia Detected by the Bispectral Index during Cardiopulmonary Bypass: A case report. |
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Eun Ho Lee, Jae Woong Choi, Sun Joon Cho, Ji Yeon Sim, Kyung Don Hahm, Yong Bo Jeong, In Cheol Choi |
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Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. icchoi@amc.seoul.kr |
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| Abstract |
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The bispectral index (BIS) has been developed as a measure for monitoring the hypnotic drug effect. EEG processing results in a BIS scale from 0 to 100, where 100 represents an awake and responsive patient, and the scale decreases when hypnotics are administered. Here we describe two patients in whom the BIS decreased to nearly 0 during cardiac surgery. Postoperatively both patients showed hypoxic brain injury. There are several possible causes for a decrease in the BIS during surgery, including deep anesthesia, hypothermia and cerebral ischemia. In the present cases, cerebral hypoperfusion was the likely cause.
During cardiac surgery, hemodynamic changes such as acute hypotension and cardiac arrest can cause cerebral ischemia.
Cerebral ischemia develops most commonly during cardiopulmonary bypass (CPB). Therefore, the BIS may be useful for detecting severe cerebral ischemia during CPB, although it has some limitations as a cerebral monitor. |
| Key Words:
bispectral index; cardiac surgery; cardiopulmonary bypass; cerebral hypoperfusion |
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