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Effects of cerebral hypoperfusion on bispectral index: a randomised, controlled animal experiment during haemorrhagic shock.
Resuscitation. 2010 Sep; 81(9):1183-9.R

Abstract

BACKGROUND

The aim of this porcine haemorrhagic shock model was to investigate the changes of bispectral index (BIS) after slow and fast recovery of cerebral perfusion, and its correlation with plasma propofol concentrations.

METHODS

After Animal Investigational Committee approval, 16 pigs during propofol anaesthesia underwent a liver trauma with severe hypotension, and were randomly assigned to receive therapy for either slow recovery (fluid resuscitation; slow group; n=8) or fast recovery of cerebral perfusion (vasopressor combined with hypertonic-saline-starch; fast group; n=8), respectively. Cerebral perfusion pressure (CPP=MAP-ICP), cerebral tissue oxygenation index (TOI), BIS, and plasma concentrations of propofol and haemoglobin were measured at baseline (Pre-shock), haemodynamic decompensation (Shock), and 5 (Therapy) and 30 min (End) after therapy, respectively.

RESULTS

CPP, TOI, and BIS decreased significantly during shock (pre-shock vs. shock, fast: CPP: 65+/-14 vs. 15+/-4 mmHg; TOI: 64+/-6 vs. 47+/-7%; BIS 60+/-5 vs. 9+/-10; slow: CPP: 60+/-12 vs. 13+/-7 mmHg; TOI: 68+/-7 vs. 49+/-7%; BIS 63+/-5 vs. 13+/-12; P<0.05). In the fast group, CPP, TOI, and BIS increased after therapy compared to the slow group (Therapy, fast: CPP: 47+/-15 mmHg, TOI: 61+/-7%, BIS: 47+/-21; slow: CPP: 18+/-9 mmHg, TOI: 51+/-5%, BIS: 21+/-19; P<0.05). Propofol and haemoglobin concentrations were comparable between groups throughout the resuscitation phase.

CONCLUSIONS

In a haemorrhagic shock scenario, therapies with different impact on cerebral perfusion resulted in differing changes of BIS values, while plasma propofol and haemoglobin concentrations were comparable during the resuscitation phase; this suggests that BIS may also have reflected changes of cerebral perfusion.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany. e.cavus@t-online.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20598424

Citation

Cavus, Erol, et al. "Effects of Cerebral Hypoperfusion On Bispectral Index: a Randomised, Controlled Animal Experiment During Haemorrhagic Shock." Resuscitation, vol. 81, no. 9, 2010, pp. 1183-9.
Cavus E, Meybohm P, Doerges V, et al. Effects of cerebral hypoperfusion on bispectral index: a randomised, controlled animal experiment during haemorrhagic shock. Resuscitation. 2010;81(9):1183-9.
Cavus, E., Meybohm, P., Doerges, V., Hoecker, J., Betz, M., Hanss, R., Steinfath, M., & Bein, B. (2010). Effects of cerebral hypoperfusion on bispectral index: a randomised, controlled animal experiment during haemorrhagic shock. Resuscitation, 81(9), 1183-9. https://doi.org/10.1016/j.resuscitation.2010.05.018
Cavus E, et al. Effects of Cerebral Hypoperfusion On Bispectral Index: a Randomised, Controlled Animal Experiment During Haemorrhagic Shock. Resuscitation. 2010;81(9):1183-9. PubMed PMID: 20598424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of cerebral hypoperfusion on bispectral index: a randomised, controlled animal experiment during haemorrhagic shock. AU - Cavus,Erol, AU - Meybohm,Patrick, AU - Doerges,Volker, AU - Hoecker,Jan, AU - Betz,M, AU - Hanss,Robert, AU - Steinfath,Markus, AU - Bein,Berthold, Y1 - 2010/07/02/ PY - 2009/12/03/received PY - 2010/04/25/revised PY - 2010/05/26/accepted PY - 2010/7/6/entrez PY - 2010/7/6/pubmed PY - 2010/12/22/medline SP - 1183 EP - 9 JF - Resuscitation JO - Resuscitation VL - 81 IS - 9 N2 - BACKGROUND: The aim of this porcine haemorrhagic shock model was to investigate the changes of bispectral index (BIS) after slow and fast recovery of cerebral perfusion, and its correlation with plasma propofol concentrations. METHODS: After Animal Investigational Committee approval, 16 pigs during propofol anaesthesia underwent a liver trauma with severe hypotension, and were randomly assigned to receive therapy for either slow recovery (fluid resuscitation; slow group; n=8) or fast recovery of cerebral perfusion (vasopressor combined with hypertonic-saline-starch; fast group; n=8), respectively. Cerebral perfusion pressure (CPP=MAP-ICP), cerebral tissue oxygenation index (TOI), BIS, and plasma concentrations of propofol and haemoglobin were measured at baseline (Pre-shock), haemodynamic decompensation (Shock), and 5 (Therapy) and 30 min (End) after therapy, respectively. RESULTS: CPP, TOI, and BIS decreased significantly during shock (pre-shock vs. shock, fast: CPP: 65+/-14 vs. 15+/-4 mmHg; TOI: 64+/-6 vs. 47+/-7%; BIS 60+/-5 vs. 9+/-10; slow: CPP: 60+/-12 vs. 13+/-7 mmHg; TOI: 68+/-7 vs. 49+/-7%; BIS 63+/-5 vs. 13+/-12; P<0.05). In the fast group, CPP, TOI, and BIS increased after therapy compared to the slow group (Therapy, fast: CPP: 47+/-15 mmHg, TOI: 61+/-7%, BIS: 47+/-21; slow: CPP: 18+/-9 mmHg, TOI: 51+/-5%, BIS: 21+/-19; P<0.05). Propofol and haemoglobin concentrations were comparable between groups throughout the resuscitation phase. CONCLUSIONS: In a haemorrhagic shock scenario, therapies with different impact on cerebral perfusion resulted in differing changes of BIS values, while plasma propofol and haemoglobin concentrations were comparable during the resuscitation phase; this suggests that BIS may also have reflected changes of cerebral perfusion. SN - 1873-1570 UR - https://www.unboundmedicine.com/medline/citation/20598424/Effects_of_cerebral_hypoperfusion_on_bispectral_index:_a_randomised_controlled_animal_experiment_during_haemorrhagic_shock_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0300-9572(10)00313-8 DB - PRIME DP - Unbound Medicine ER -