The optimal temperature for deep hypothermic circulatory arrest remains undefined. We present a case in which Bispectral Index monitoring during hypothermic cardiopulmonary bypass showed electrocerebral silence at a higher temperature than previously reported. Bispectral Index monitoring may be a potentially useful tool in surgery employing deep hypothermic circulatory arrest.
CoselliJ.S., CrawfordE.S., BeallA.C.Determination of brain temperatures for safe circulatory arrest during cardiovascular operations.Ann Thorac Surg1988; 45: 638–642.
3.
GanzelB.L., EdmondsH.L., PankJ.R., and GoldsmithL.J.Cardiopulmonary bypass, myocardial management, and support techniques.J Thorac Cardiovasc Surg1997; 113: 748–757.
4.
SealyW.C., BrownI.W.Jr., YoungW.G.Jr.A report on the use of both extracorporeal circulation and hypothermia for open-heart surgery.Ann Surg1958; 147: 603–613.
5.
SteckerM.M., CheungA.T., PochettinoA.Deep hypo-thermic circulatory arrest: I. Effects of cooling on electroencephalogram and evoked potentials.Ann Thorac Surg2001; 71: 14–21.
6.
MizrahiE.M., PatelV.M., CrawfordE.S.Hypothermia-induced electrocerebral silence, prolonged circulatory arrest and cerebral protection during cardiovascular surgery.Electroencephalog Clin Neurophysiol1989; 72: 81–85.
7.
BIS Question and Answer Guide.Aspect Medical Systems MA, USA.
8.
BloomM.J.Electoencephalography and Monitoring of Anesthetic Depth. In: Clinical Monitoring: Practical Applications in Anesthesia and Critical Care.LakeC.L., HinesR.L., BlittC.D. eds. W. B. Saunders Company2000; pp. 98–99.
9.
Valerie Billard.Brain injury under general anaesthesia: is monitoring of the EEG helpful? Editorial.Can J Anesth2001; 48: 1057–1060.
10.
KahnR.A.EEG monitoring is required during hypothermic circulatory arrest (Con).Newsletter of the Society of Cardiovascular Anesthesiologists October 2001; 5–6.
11.
SchmidlinD., HagerP., SchmidE.R.Monitoring level of sedation with bispectral EEG analysis: comparison between hypothermic and normothermic cardiopulmonary bypass.Br J Anaesth2001; 86: 769–776.
12.
DoiM., GajrajR.J., MantzaridsH.Effects of cardiopul-monary bypass and hypothermia on electroencephalographic variables.Anaesthesia1997; 52: 1048–1055.
13.
AlkireM.T.Quantitative EEG correlations with brain glucose metabolic rate during anesthesia in volunteers.Anesthesiology1998; 89: 323–333.
14.
StanskiD.R.Monitoring Depth of Anesthesia. In: Anesthesia, Miller RD ed. 5th Ed.Churchill Livingstone2000; 1112.