Abstract
IntroductionNeuromonitoring (electroencephalogram [EEG] and cerebral oximetry) is essential for appropriate anesthesia and neuroprotection assessment during pediatric cardiac surgery.MethodsWe describe the intraoperative pediatric multimodal and multiparametric neuromonitoring pattern of the software system Neuron-Spectrum (Kandel®) that consists of continuous electroencephalogram (cEEG), spectral analysis, amplitude-integrated electroencephalogram (aEEG), depth of anesthesia monitor (NINDEX), and regional cerebral and somatic oximetry (near-infrared spectroscopy-INVOS™). A physiological algorithm for management using neuromonitoring and physiological data is also described.ResultsVisual data examples are presented for interpretation of the cerebral perfusion and oxygenation, neurophysiological state, anesthesia depth, possible neurologic predictions, and identification of cerebral drug effects (EEG signature). Conclusion: The neuromonitoring model can be an effective tool for anesthesia control and to provide adequate cerebral oxygenation during surgery.
Highlights
Neuromonitoring is essential for appropriate anesthesia and neuroprotection assessment during pediatric cardiac surgery
Visual data examples are presented for interpretation of the cerebral perfusion and oxygenation, neurophysiological state, anesthesia depth, possible neurologic predictions, and identification of cerebral drug effects (EEG signature)
The neuromonitoring model can be an effective tool for anesthesia control and to provide adequate cerebral oxygenation during surgery
Summary
Neuromonitoring (electroencephalogram [EEG] and cerebral oximetry) is essential for appropriate anesthesia and neuroprotection assessment during pediatric cardiac surgery. Real-time neurologic and cardiorespiratory function, central temperature, inhaled anesthetic concentrations, and renal function monitoring should be an integral part of depth anesthesia monitoring and neuroprotective strategies for pediatric patients requiring major surgery, such as cardiac and major abdominal surgeries, neonates. These allow swift and appropriate management to provide appropriate anesthesia level and drug combinations and detect and counteract cerebral oxygenation decreasing. Klamt JG, et al - Intraoperative Polymodal Pediatric Neuromonitoring for detecting adverse outcome events and their causes and adequate anesthesia level
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