Neuromonitoring in the cardiopulmonary bypass surgical patient: clinical applications

Intraoperative multimodality neurodiagnostic monitoring utilizing a transcranial Doppler, electroencephalography (EEG), and cerebral oximetry has been shown to reduce the incidence of neurological complications greatly. Potential problems affecting the brain can be detected and resolved or managed before disastrous consequences result. The use of multimodality neuromonitoring combined with traditional hemodynamic monitoring provides the clinician with additional data to manage the cardiac/vascular surgical patient better. Because the brain has the highest blood flow and metabolic demand of any organ, it seems the ideal and most logical place to monitor the adequacy of body perfusion. This review discusses our experiences and research over the last decade with the use of multimodality EEG monitoring on cardiopulmonary bypass surgical patients.