Multimodal Neuromonitoring During Pediatric Cardiac Surgery

• Autor(a) principal: Klamt,Jyrson Guilherme
• Data de Publicação: 2022
• Outros Autores: Garcia,Waynice Neiva de Paula, Carvalho,Mariana de, Garcia,Luis Vicente, Menardi,Antonio Carlos
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000200251
• topic: Neuroprotection; Child; Cardiac Surgical Procedures; Anesthesia; Electroencephalography; Near-infrared Spectroscopy

Abstract Introduction: Neuromonitoring (electroencephalogram [EEG] and cerebral oximetry) is essential for appropriate anesthesia and neuroprotection assessment during pediatric cardiac surgery. Methods: We 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. Results: 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). Conclusion: The neuromonitoring model can be an effective tool for anesthesia control and to provide adequate cerebral oxygenation during surgery.