Multimodal Neuromonitoring During Pediatric Cardiac Surgery

Area of Science:

• Neuroscience
• Anesthesiology
• Pediatric Cardiac Surgery

Background:

• Neuromonitoring, including electroencephalogram (EEG) and cerebral oximetry, is critical for managing anesthesia and neuroprotection in pediatric cardiac surgery.
• Effective intraoperative monitoring is essential to optimize patient outcomes and prevent neurological complications.

Purpose of the Study:

• To describe the intraoperative pediatric multimodal and multiparametric neuromonitoring pattern using the Neuron-Spectrum (Kandel®) software system.
• To present a physiological algorithm for management based on neuromonitoring and physiological data.

Main Methods:

• Utilized continuous electroencephalogram (cEEG), spectral analysis, amplitude-integrated electroencephalogram (aEEG), depth of anesthesia monitoring (NINDEX), and regional cerebral oximetry (near-infrared spectroscopy-INVOS™).
• Integrated a physiological algorithm for data interpretation and management decisions.

Main Results:

• Presented visual data examples for interpreting cerebral perfusion, oxygenation, and neurophysiological state.
• Demonstrated the identification of anesthesia depth, potential neurological predictions, and drug effects (EEG signature).

Conclusions:

• The described neuromonitoring model is an effective tool for anesthesia control.
• This approach facilitates the provision of adequate cerebral oxygenation during pediatric cardiac surgery.