Cerebral function monitor during open heart surgery

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The objective of cardiac surgery is to return the patient to as normal a state as possible. A successful surgical result must be accompanied by the recovery of function of the cardiovascular, pulmonary, renal, and neurologic subsystems. The recovery of the last of these systems has been most difficult to ensure after open heart surgery. Rapid advances in monitoring hemodynamic and respiratory functions have increased patient safety; however, the monitoring of cerebral function has not kept pace with these advances.1

Since 1975 we have used the cerebral function monitor* in our operating suite in an effort to ascertain first and then to correct those situations that may result in neurologic dysfunction in the postoperative period. The cerebral function monitor is designed to process the cerebral electrical activity and display it in an easily interpretable fashion. The device has some advantages over the conventional electroencephalogram (EEG), including simplicity, cost, size, safety, and reliability. The details of electronics of the cerebral function monitor have been reported.2–4

This report is based on 650 patients who had undergone surgery for acquired and congenital heart diseases and who had been attached to the cerebral function monitor during the entire operative procedure. The purpose of this communication is to analyze the clinically important observations that occur in the cerebral electrical activity recording during normothermic perfusion, deep hypothermia, and during untoward events, e.g., hypotension, technical complications during perfusion, and uncontrolled . . .



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