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Neurophysiologisches Monitoring bei kardiochirurgischen Eingriffen

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Neuromonitoring in Anästhesie und Intensivmedizin

Part of the book series: Klinische Anästhesiologie und Intensivtherapie ((KAI,volume 46))

Zusammenfassung

Die Zahl neurologischer oder neuropsychologischer Auffälligkeiten nach kardiochirurgischen Eingriffen mit extrakorporaler Zirkulation lag in prospektiven Studien zwischen 30 und 60% [7, 32]. Tödliche zerebrale Komplikationen traten nach aortokoronaren Bypassoperationen in 0,3–0,7% [6, 31] und nach Operationen am offenen Herzen in 2% auf [33]. Zielsetzung des neurophysiologischen Monitorings ist es, eine globale oder regionale zerebrale Ischämie sofort zu erkennen und therapeutisch einzugreifen, um die Zahl und das Ausmaß neurologischer Schäden zu verringern. Der Nutzen von EEG-Monitoring zur Ischämieerkennung wurde bisher mit Kasuistiken und retrospektiven Untersuchungen belegt [12, 16, 28].

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Literatur

  1. Arén C, Badr G, Feddersen K, Radegran K (1985) Somatosensory evoked potentials and cerebral metabolism during cardiopulmonary bypass with special reference to hypotension induced by prostacyclin infusion. J Thorac Cardiovasc Surg 90: 73–79

    PubMed  Google Scholar 

  2. Arom KV, Cohen DE, Strobl FT (1989) Effect of intraoperative intervention on neurological outcome based on electroencephalographic monitoring during cardiopulmonary bypass. Ann Thorac Surg 48: 476–483

    Article  PubMed  CAS  Google Scholar 

  3. Astrup J, Symon L, Branston NM, Lassen NA (1977) Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischaemia. Stroke 8: 51–57

    Article  PubMed  CAS  Google Scholar 

  4. Bashein G, Nessly ML, Bledsoe SW, Townes BD, Davis KB, Coppel DB, Hornbein TF (1992) Electroencephalography during surgery with cardiopulmonary bypass and hypothermia. Anesthesiology 76: 878–891

    Article  PubMed  CAS  Google Scholar 

  5. Blauth CI, Arnold JV, Schulenberg WE, McCartney AC, Tylor KM (1988) Cerebral microembolism during cardiopulmonary bypass. Retinal microvascular studies in vivo with fluorescine angiography. J Thorac Cardiovasc Surg 95: 668–676

    PubMed  CAS  Google Scholar 

  6. Breuer AC, Furlan AJ, Hanson MR et al. (1981) Neurologic complications of open heart surgery. Clevel Clin Quart 48: 205–206

    CAS  Google Scholar 

  7. Breuer AC, Furlan AJ, Hanson MR (1983) Central nervous system complications of coronary artery bypass graft surgery: a prospective analysis of 421 patients. Stroke 14: 682–687

    Article  PubMed  CAS  Google Scholar 

  8. Coons RE, Keats AS, Cooley DA (1959) Significance of electroencephalographic changes occuring during cardiopulmonary bypass. Anesthesiology 20: 804–810

    Article  PubMed  CAS  Google Scholar 

  9. Davenport HT, Arfel G, Sanchez FR (1959) The electroencephalogram in patients undergoing open heart surgery with heart-lung bypass. Anesthesiology 20: 674–684

    Article  PubMed  CAS  Google Scholar 

  10. Edmonds HL, Griffiths LK, Laken J van der, Slater AD, Shields CB (1992) Quantitative electroencephalographic monitoring during myocardial revascularization predicts postoperative disorientation and improves outcome. J Thorac cardiovasc Surg 103: 555–563

    PubMed  Google Scholar 

  11. Edmonds HL, Rodriguez RA, Shields CB (1994) Quantitaive EEG (QEEG) neuromonitoring during cardiac surgery: Experience in 600 cases. Perfusion (in press)

    Google Scholar 

  12. El-Fiki M, Fish KJ (1987) Is the EEG a useful monitor during cardiac surgery? A case report. Anesthesiology 67: 575–578

    Article  PubMed  CAS  Google Scholar 

  13. Engelhardt W (1992) N100 und P300 vor und nach aortokoronarer Bypassoperation. Anaesthesist 41: 724–725

    Google Scholar 

  14. Engelhardt W, Dierks T, Pause M, Hartung E, Sold M, Silber R (1994) Comparison of EEG-maps before and after coronary artery bypass surgery. BrainTopogr (in press)

    Google Scholar 

  15. John ER, Prichep LS, Chabot RJ, Isom WO (1989) Monitoring brain function during cardiovascular surgery: hypoperfusion vs. microembolism as the major cause of neurological damage during cardiopulmonary bypass. In: Refsum H, Sulg IA, Rasmussen K (eds) Heart & brain, brain & heart. Springer, Berlin Heidelberg New York Tokyo, pp 405–421

    Google Scholar 

  16. Jones BR, Scheller MS (1989) Perfusion pressure and electroencephalographic changes during cardiopulmonary bypass. J Clin Monit 5: 288

    Article  PubMed  CAS  Google Scholar 

  17. Levy WJ (1992) Monitoring of the electroencephalogram during cardiopulmonary bypass — Know when to say when. Anesthesiology 76: 876–877

    Article  PubMed  CAS  Google Scholar 

  18. Malone M, Prior P, Scholtz CL (1981) Brain damage after cardiopulmonary by-pass: correlations between neurophysiological and neuropathological findings. J Neurol Neurosurg Psychiatry 44: 924–931

    Article  PubMed  CAS  Google Scholar 

  19. Markand ON, Warren CH, Moorthy SS, Stoelting RK, King RD (1984) Monitoring of multimodality evoked potentials during open heart surgery under hypothermia. Electroence-phalogr Clin Neurophysiol 59: 432–440

    Article  CAS  Google Scholar 

  20. Metz S, Slogoff S (1990) Thiopental sodium by single bolus dose compared to infusion for cerebral protection during cardiopulmonary bypass. J Clin Anesth 2: 226–231

    Article  PubMed  CAS  Google Scholar 

  21. Mizrahi EM, Patel VM, Crawford ES, Coselli JS, Hess KR (1989) Hypothermic-induced electrocerebral silence, prolonged circulatory arrest, and cerebral protection during cardiovascular surgery. Electroencephalogr Clin Neurophysiol 72: 81–85

    Article  PubMed  CAS  Google Scholar 

  22. Nussmeier NA, McDermott JP (1988) Macroembolization: prevention and outcome modification. In: Hilberman M (ed) Brain injury and protection during heart surgery. Nijhoff, Boston Dordrecht Lancaster, pp 85–108

    Chapter  Google Scholar 

  23. Nuwer MR (1986) Evoked potential monitoring in the operating room. Raven, New York

    Google Scholar 

  24. Nuwer MR (1988) Use of somatosensory evoked potentials for intraoperative monitoring of cerebral and spinal cord function. Neurol Clin 6: 881–897

    PubMed  CAS  Google Scholar 

  25. Patterson RH, Rosenfeld L, Porro RS (1976) Transitory cerebral microvascular blockade after cardiopulmonary bypass. Thorax 31: 736–741

    Article  PubMed  Google Scholar 

  26. Quasha AL, Tinker JH, Sharbrough FW (1981) Hypothermia plus thiopental: Prolonged electroencephalographic suppression. Anesthesiology 55: 636–640

    Article  PubMed  CAS  Google Scholar 

  27. Ross Russell RW, Bharucha N (1978) The recognition and prevention of border zone ischemia during cardiac surgery. Q J Med 187: 303–323

    Google Scholar 

  28. Salerno TA, Lince DP, White DN, Lynn RB, Charrette EJP (1978) Monitoring of electroencephalogram during open heart surgery. J Thorac Cardiovasc Surg 76: 97–100

    PubMed  CAS  Google Scholar 

  29. Scheller MS (1992) Routine barbiturate brain protection during cardiopulmonary bypass cannot be recommended. J Neurosurgical Anesthesiol 4: 60–63

    Article  CAS  Google Scholar 

  30. Sebel PS, Bruijn NP de, Neville WK (1988) Effect of hypothermia on median nerve somatosensory evoked potentials. J Cardiothorac Vasc Anesth 2: 326–329

    Article  CAS  Google Scholar 

  31. Shaw PJ, Bates D, Cartlidge NEF, Heaviside D, Julian DG, Shaw DA (1985) Early neurological complications of coronary artery bypass surgery. Br Med J 291: 1384–1386

    Article  CAS  Google Scholar 

  32. Smith PLC, Treasure T, Newman SP, Joseph P, Ell PJ, Schneidau A, Harrison MJG (1986) Cerebral consequences of cardiopulmonary bypass. Lancet 1: 823–825

    Article  PubMed  CAS  Google Scholar 

  33. Sotaniemi KA (1980) Clinical and prognostic correlates of EEG in open-heart surgery patients. J Neurol Neurosurg Psychiatry 43: 941–947

    Article  PubMed  CAS  Google Scholar 

  34. Stockard JJ, Bickford RG, Schauble JF (1973) Pressuredependent cerebral ischemia during cardiopulmonary bypass. Neurology 23: 521–529

    PubMed  CAS  Google Scholar 

  35. Theye RA, Patrick R, Kirklin JW (1957) The electroencephalogram in patients underoging open intracardiac operations with the aid of extracorporeal circulation. J Thorac Surg 34: 709–717

    PubMed  CAS  Google Scholar 

  36. Zaidan JR, Klochany A, Martin WM, Ziegler JS, Harless DM, Andrews RB (1991) Effect of thiopental on neurologic outcome following coronary artery bypass grafting. Anesthesiology 74: 406–411

    Article  PubMed  CAS  Google Scholar 

  37. Zeitlhofer J, Saletu B, Anderer P, Asenbaum S, Spiss C, Mohl W, Kasall H, Wolner E, Deecke L (1988) Topographic brain mapping of EEG before and after open-heart surgery. Neuropsychobiology 20: 51–56

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. W. Engelhardt
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E. Rügheimer M. Dinkel

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© 1994 Springer-Verlag Berlin Heidelberg

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Engelhardt, W. (1994). Neurophysiologisches Monitoring bei kardiochirurgischen Eingriffen. In: Rügheimer, E., Dinkel, M. (eds) Neuromonitoring in Anästhesie und Intensivmedizin. Klinische Anästhesiologie und Intensivtherapie, vol 46. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78752-2_16

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  • DOI: https://doi.org/10.1007/978-3-642-78752-2_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-57611-2

  • Online ISBN: 978-3-642-78752-2

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