Coronary artery bypass surgery central nervous system monitoring

Jump to navigation Jump to search

Coronary Artery Bypass Surgery Microchapters

Home

Patient Information

Overview

Pathophysiology

Saphenous Vein Graft Disease
Other Non-Atherosclerotic Saphenous Vein Graft Diseases

Indications for CABG

Prognosis

Diagnosis

Imaging in the Patient Undergoing CABG

Chest X Ray

Angiography

CT Angiography
MRI Angiography

Trans-Esophageal Echocardiography

Treatment

Goals of Treatment

Perioperative Management

Perioperative Monitoring

Electrocardiographic Monitoring
Pulmonary Artery Catheterization
Central Nervous System Monitoring

Surgical Procedure

Anesthetic Considerations
Intervention in left main coronary artery disease
The Traditional Coronary Artery Bypass Grafting Procedure (Simplified)
Minimally Invasive CABG
Hybrid coronary revascularization
Conduits Used for Bypass
Videos on Spahenous Vein Graft Harvesting
Videos on Coronary Artery Bypass Surgery

Post-Operative Care and Complications

Pharmacotherapy in patients undergoing CABG CABG

Special Scenarios

Anomalous Coronary Arteries
COPD/Respiratory Insufficiency
Existing Renal Disease
Concomitant Valvular Disease
Previous Cardiac Surgery
Menopause
Carotid Disease evaluation before surgery

Coronary artery bypass surgery central nervous system monitoring On the Web

Most recent articles

Most cited articles

Review articles

CME programs

powerpoint slides

Images

Ongoing trials at clinical trials.gov

US National guidelines clearinghouse

NICE guidance

FDA on Coronary artery bypass surgery central nervous system monitoring

CDC on Coronary artery bypass surgery central nervous system monitoring

Coronary artery bypass surgery central nervous system monitoring in the news

Blogs on Coronary artery bypass surgery central nervous system monitoring|-

Directions to Hospitals Performing Coronary artery bypass surgery central nervous system monitoring

Risk calculators for Coronary artery bypass surgery central nervous system monitoring

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2] Anahita Deylamsalehi, M.D.[3]

2021 ACA revascularization Guideline [1][2][3][4][5][6][7][8][9][10][11][12]

Cerebral Oxygen Saturation Monitoring of cerebral oxygen saturation during the operation (by using near infrared spectroscopy) can be utilized to detect cerebral hypoperfusion and has been demonstrated to help anesthetic decision-making. Furthermore, there is evidence that shows it might be able to prevent postoperative neurocognitive dysfunction.
Processed Electroencephalogram Although there are inconsistent data on routine use of intraoperative monitoring of processed electroencephalogram (i.e., bispectral index), some evidence demonstrates its benefits in recall prevention, controlling the depth of anesthesia, or improvement in recovery rate after cardiac surgery.

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)[13]

Class IIb
"1. The effectiveness of intraoperative monitoring of the processed electroencephalogram to reduce the possibility of adverse recall of clinical events or for detection of cerebral hypoperfusion in CABG patients is uncertain.[14][15][16] (Level of Evidence: B)"
"2. The effectiveness of routine use of intraoperative or early postoperative monitoring of cerebral oxygen saturation via near-infrared spectroscopy to detect cerebral hypoperfusion in patients undergoing CABG is uncertain.[17][18][19] (Level of Evidence: B)"

Guidelines Resources

  • 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines[13]
  • 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.[20]

References

  1. Zorrilla-Vaca A, Healy R, Grant MC, Joshi B, Rivera-Lara L, Brown C; et al. (2018). "Intraoperative cerebral oximetry-based management for optimizing perioperative outcomes: a meta-analysis of randomized controlled trials". Can J Anaesth. 65 (5): 529–542. doi:10.1007/s12630-018-1065-7. PMID 29427259.
  2. Colak Z, Borojevic M, Bogovic A, Ivancan V, Biocina B, Majeric-Kogler V (2015). "Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized, prospective study". Eur J Cardiothorac Surg. 47 (3): 447–54. doi:10.1093/ejcts/ezu193. PMID 24810757.
  3. Kara I, Erkin A, Saclı H, Demirtas M, Percin B, Diler MS; et al. (2015). "The Effects of Near-Infrared Spectroscopy on the Neurocognitive Functions in the Patients Undergoing Coronary Artery Bypass Grafting with Asymptomatic Carotid Artery Disease: A Randomized Prospective Study". Ann Thorac Cardiovasc Surg. 21 (6): 544–50. doi:10.5761/atcs.oa.15-00118. PMC 4905032. PMID 26133933.
  4. Vretzakis G, Georgopoulou S, Stamoulis K, Tassoudis V, Mikroulis D, Giannoukas A; et al. (2013). "Monitoring of brain oxygen saturation (INVOS) in a protocol to direct blood transfusions during cardiac surgery: a prospective randomized clinical trial". J Cardiothorac Surg. 8: 145. doi:10.1186/1749-8090-8-145. PMC 3691733. PMID 23758929.
  5. Rogers CA, Stoica S, Ellis L, Stokes EA, Wordsworth S, Dabner L; et al. (2017). "Randomized trial of near-infrared spectroscopy for personalized optimization of cerebral tissue oxygenation during cardiac surgery". Br J Anaesth. 119 (3): 384–393. doi:10.1093/bja/aex182. PMID 28969313.
  6. Ramsey SD, Saint S, Sullivan SD, Dey L, Kelley K, Bowdle A (2000). "Clinical and economic effects of pulmonary artery catheterization in nonemergent coronary artery bypass graft surgery". J Cardiothorac Vasc Anesth. 14 (2): 113–8. doi:10.1016/s1053-0770(00)90001-6. PMID 10794325.
  7. Uysal S, Lin HM, Trinh M, Park CH, Reich DL (2020). "Optimizing cerebral oxygenation in cardiac surgery: A randomized controlled trial examining neurocognitive and perioperative outcomes". J Thorac Cardiovasc Surg. 159 (3): 943–953.e3. doi:10.1016/j.jtcvs.2019.03.036. PMID 31056357.
  8. Deschamps A, Hall R, Grocott H, Mazer CD, Choi PT, Turgeon AF; et al. (2016). "Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery: A Randomized Controlled Feasibility Trial". Anesthesiology. 124 (4): 826–36. doi:10.1097/ALN.0000000000001029. PMID 26808629.
  9. Kertai MD, Pal N, Palanca BJ, Lin N, Searleman SA, Zhang L; et al. (2010). "Association of perioperative risk factors and cumulative duration of low bispectral index with intermediate-term mortality after cardiac surgery in the B-Unaware Trial". Anesthesiology. 112 (5): 1116–27. doi:10.1097/ALN.0b013e3181d5e0a3. PMID 20418692.
  10. Vance JL, Shanks AM, Woodrum DT (2014). "Intraoperative bispectral index monitoring and time to extubation after cardiac surgery: secondary analysis of a randomized controlled trial". BMC Anesthesiol. 14: 79. doi:10.1186/1471-2253-14-79. PMC 4172314. PMID 25249789.
  11. Villafranca A, Thomson IA, Grocott HP, Avidan MS, Kahn S, Jacobsohn E (2013). "The impact of bispectral index versus end-tidal anesthetic concentration-guided anesthesia on time to tracheal extubation in fast-track cardiac surgery". Anesth Analg. 116 (3): 541–8. doi:10.1213/ANE.0b013e31827b117e. PMID 23400982.
  12. Vretzakis G, Ferdi E, Argiriadou H, Papaziogas B, Mikroulis D, Lazarides M; et al. (2005). "Influence of bispectral index monitoring on decision making during cardiac anesthesia". J Clin Anesth. 17 (7): 509–16. doi:10.1016/j.jclinane.2004.12.018. PMID 16297750.
  13. 13.0 13.1 Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG; et al. (2011). "2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. doi:10.1161/CIR.0b013e31823c074e. PMID 22064599.
  14. Avidan MS, Zhang L, Burnside BA, Finkel KJ, Searleman AC, Selvidge JA, Saager L, Turner MS, Rao S, Bottros M, Hantler C, Jacobsohn E, Evers AS (2008). "Anesthesia awareness and the bispectral index". The New England Journal of Medicine. 358 (11): 1097–108. doi:10.1056/NEJMoa0707361. PMID 18337600. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  15. Hemmerling TM, Olivier JF, Basile F, Le N, Prieto I (2005). "Bispectral index as an indicator of cerebral hypoperfusion during off-pump coronary artery bypass grafting". Anesthesia and Analgesia. 100 (2): 354–6. doi:10.1213/01.ANE.0000140245.44494.12. PMID 15673855. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  16. Myles PS, Leslie K, McNeil J, Forbes A, Chan MT (2004). "Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial". Lancet. 363 (9423): 1757–63. doi:10.1016/S0140-6736(04)16300-9. PMID 15172773. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  17. Brady K, Joshi B, Zweifel C, Smielewski P, Czosnyka M, Easley RB, Hogue CW (2010). "Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass". Stroke; a Journal of Cerebral Circulation. 41 (9): 1951–6. doi:10.1161/STROKEAHA.109.575159. PMID 20651274. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  18. Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, Cleland A, Schaefer B, Irwin B, Fox S (2007). "Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study". Anesthesia and Analgesia. 104 (1): 51–8. doi:10.1213/01.ane.0000246814.29362.f4. PMID 17179242. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  19. Slater JP, Guarino T, Stack J, Vinod K, Bustami RT, Brown JM, Rodriguez AL, Magovern CJ, Zaubler T, Freundlich K, Parr GV (2009). "Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery". The Annals of Thoracic Surgery. 87 (1): 36–44, discussion 44–5. doi:10.1016/j.athoracsur.2008.08.070. PMID 19101265. Retrieved 2011-12-16. Unknown parameter |month= ignored (help)
  20. Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM; et al. (2022). "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". J Am Coll Cardiol. 79 (2): e21–e129. doi:10.1016/j.jacc.2021.09.006. PMID 34895950 Check |pmid= value (help).

Template:WH Template:WS