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Related Experiment Videos

Falsely elevated bispectral index during deep hypothermic circulatory arrest.

G Mychaskiw1, B J Heath, J H Eichhorn

  • 1University of Mississippi School of Medicine, University of Mississippi Medical Center, Jackson 39216-4505, USA.

British Journal of Anaesthesia
|November 30, 2000
PubMed
Summary

Erroneous Bispectral Index (BIS) monitor readings during infant heart surgery could lead to dangerous changes in patient management. This case highlights the importance of vigilance with neuromonitoring devices in pediatric cardiac procedures.

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Area of Science:

  • Pediatric Cardiac Surgery
  • Neuroanesthesia
  • Medical Device Monitoring

Background:

  • Ventricular septal defects (VSDs) are common congenital heart abnormalities requiring surgical repair.
  • Deep hypothermic circulatory arrest (DHCA) is a critical component of complex infant cardiac surgeries.
  • Intraoperative neuromonitoring, such as Bispectral Index (BIS), is used to assess cerebral function during cardiopulmonary bypass.

Observation:

  • A 2-month-old infant undergoing VSD repair with DHCA had neuromonitoring assessed using an Aspect BIS monitor.
  • The study focused on the Bispectral Index (BIS) and EEG suppression ratio.
  • Potential for erroneous monitor readings was identified.

Findings:

  • The Aspect BIS monitor provided readings for Bispectral Index (BIS) and EEG suppression ratio.

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  • There was a risk that inaccurate data from the BIS monitor could have influenced surgical and anesthetic decisions.
  • This highlights a potential vulnerability in the use of this technology during critical pediatric cardiac surgery.

    • Implications:

    • Clinicians must be aware of the potential for false or misleading data from neuromonitoring devices.
    • Careful correlation of monitor data with clinical signs is crucial, especially in high-risk pediatric surgical populations.
    • Ensuring the reliability of intraoperative monitoring is paramount to patient safety during complex congenital heart defect repairs.