Processed electroencephalography: impact of patient age and surgical position on intraoperative processed electroencephalogram monitoring of burst-suppression.

We previously reported that processed EEG underestimated the amount of burst suppression compared to off-line visual analysis. We performed a follow-up study to evaluate the reasons for the discordance. Forty-five patients were monitored intraoperatively with processed EEG. A computer algorithm was...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 36; no. 4; pp. 1099 - 1108
Autores principales: Pleasants, D., Zak, R., Ashbrook, L. H., Zhang, L., Tang, C., Tran, D., Wang, M., Tabatabai, S., Leung, J. M.
Formato: Journal Article
Publicado: Springer Nature Aug2022
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Processed electroencephalography: impact of patient age and surgical position on intraoperative processed electroencephalogram monitoring of burst-suppression.
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          Pleasants, D.
          Zak, R.
          Ashbrook, L. H.
          Zhang, L.
          Tang, C.
          Tran, D.
          Wang, M.
          Tabatabai, S.
          Leung, J. M.
        affil: Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
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        subj:
          Intraoperative Monitoring Methods
          Electroencephalography Methods
          Prospective Studies
          Aged
          Algorithms
          Impact of Events Scale
          Aged: 65+ years
      ab: We previously reported that processed EEG underestimated the amount of burst suppression compared to off-line visual analysis. We performed a follow-up study to evaluate the reasons for the discordance. Forty-five patients were monitored intraoperatively with processed EEG. A computer algorithm was used to convert the SedLine® (machine)-generated burst suppression ratio into a raw duration of burst suppression. The reference standard was a precise off-line measurement by two neurologists. We measured other potential variables that may affect machine accuracy such as age, surgery position, and EEG artifacts. Overall, the median duration of bust suppression for all study subjects was 15.4 min (Inter-quartile Range [IQR] = 1.0-20.1) for the machine vs. 16.1 min (IQR = 0.3-19.7) for the neurologists' assessment; the 95% limits of agreement fall within - 4.86 to 5.04 s for individual 30-s epochs. EEG artifacts did not affect the concordance between the two methods. For patients in prone surgical position, the machine estimates had significantly lower overall sensitivity (0.86 vs. 0.97; p = 0.038) and significantly wider limits of agreement ([- 4.24, 3.82] seconds vs. [- 1.36, 1.13] seconds, p = 0.001) than patients in supine position. Machine readings for younger patients (age < 65 years) had higher sensitivity (0.96 vs 0.92; p = 0.021) and specificity (0.99 vs 0.88; p = 0.007) for older patients. The duration of burst suppression estimated by the machine generally had good agreement compared with neurologists' estimation using a more precise off-line measurement. Factors that affected the concordance included patient age and position during surgery, but not EEG artifacts.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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