QEEG Changes During Carotid Clamping in Carotid Endarterectomy: Spectral Edge Frequency Parameters and Relative Band Power Parameters

Autor: R.J. Veldhuizen, George H. Wieneke, Alexander C. van Huffelen, Hans van Duijn, David M. Laman
Rok vydání: 2005
Předmět:
Male
Logarithm
SURGERY
Physiology
medicine.medical_treatment
HYPOXIA
Carotid endarterectomy
Electroencephalography
CEREBRAL BLOOD-FLOW
Carotid Stenosis
EEG
EEG CHANGES
Propofol
Endarterectomy
Carotid
Isoflurane
HYPERVENTILATION
medicine.diagnostic_test
Constriction
SEF
ISCHEMIA
Carotid Arteries
Databases as Topic
Neurology
Anesthesia
Anesthetics
Inhalation
Female
TRIAL
Spectral edge frequency
carotid endarterectomy
Anesthetics
Intravenous
Shunt (electrical)
medicine.drug
Sensitivity and Specificity
STENOSIS
quantitative
QUANTITATIVE EEG
Monitoring
Intraoperative
Physiology (medical)
medicine
Humans
Electrodes
Retrospective Studies
Receiver operating characteristic
business.industry
Numerical Analysis
Computer-Assisted
shunt
monitoring
ROC Curve
Neurology (clinical)
business
Biomedical engineering
Zdroj: Journal of Clinical Neurophysiology, 22(4), 244-252. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 0736-0258
DOI: 10.1097/01.wnp.0000167931.83516.cf
Popis: Intraoperative monitoring is needed to identify accurately those patients in need of a shunt during carotid endarterectomy. EEG can be used for this purpose, but there is no consensus on the variables to use. Using a database consisting of 149 EEGs recorded from patients during carotid endarterectomy under isoflurane (n = 61) or propofol (n = 88) anesthesia and who did or did not receive a shunt, the authors investigated which of 16 derivations (common reference, Cz) and 12 parameters (relative and absolute powers and spectral edge frequencies [SEFs]) singly or in combination could best distinguish between the shunt and the nonshunt groups for the two anesthesia regimens. Receiver operating characteristic curves were used to select derivation/parameter combinations for three types of trend computation: (1) values of relative powers and SEFs during clamping (C) only, (2) clamp minus preclamp (baseline) differences (C-B), and (3) C-B differences in absolute logarithmic power (Delta logP). For both anesthesia regimens, C-B computation distinguished best between the shunt and nonshunt groups. For isoflurane anesthesia, SEF parameters were the best, and for propofol anesthesia the relative power parameters. Discriminant analysis, in which additional derivation/parameter combinations were added, increased the discriminative power of the Delta logP computation but not of the C or C-B computations. For isoflurane anesthesia, SEF 90% was the best single parameter for distinguishing between patients who did and did not need a shunt and the four best derivations were F3-Cz, P4-Cz, C4-Cz, and F7-Cz. For the propofol anesthesia, the relative power (C or C-B computations) of the delta band was the best and the four best derivations were F8-Cz, T4-Cz, C4-Cz, and F4-Cz.
Databáze: OpenAIRE
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