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Cited by 29Aortic Disease and Treatment ApproachesCardiac and Coronary Surgery TechniquesAortic aneurysm repair treatments

Electroencephalography During Hemiarch Replacement With Moderate Hypothermic Circulatory Arrest

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Keenan, Jeffrey E., Wang, Hanghang, Ganapathi, Asvin M., Englum, Brian R., Kale, Emily, Mathew, Joseph P., Husain, Aatif M., Hughes, G. Chad·2016·The Annals of Thoracic Surgery
DOI 10.1016/j.athoracsur.2015.08.002PMC PMC5140096
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Abstract

Background This study aimed to characterize intraoperative electroencephalography (EEG) during moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP), which has not been described previously. Methods This was a single-institution retrospective study of patients undergoing aortic hemiarch replacement using MHCA (temperatures <28°C at circulatory arrest [CA]) and unilateral SACP with EEG monitoring from July 1, 2013 to November 1, 2014. The EEG pattern was determined before and immediately after CA, as well as after establishment of SACP. Patient and procedural characteristics and outcomes were determined and compared after stratification by the presence of ischemic EEG changes. Results The study included 71 patients. Before CA, 47 patients (66%) demonstrated a continuous EEG pattern, with or without periodic complexes, and 24 (34%) had a burst suppression EEG pattern. Immediately after CA, abrupt loss of electrocerebral activity occurred in 32 patients (45%), suggestive of cerebral ischemia. Establishment of unilateral SACP rapidly restored electrocerebral activity in all but 2 patients. One patient had persistent loss of left-sided activity, which resolved after transition to bilateral SACP. Another patient had persistent global loss of activity and was placed back on cardiopulmonary bypass for further cooling before reinitiation of CA. No significant differences in characteristics or outcomes were assessed between patients with and without loss of EEG activity. Conclusions Nearly half of patients undergoing hemiarch replacement with MHCA/SACP experience abrupt loss of electrocerebral activity after CA is initiated. Although unilateral SACP usually restores prearrest electrocerebral activity, intraoperative EEG may be particularly valuable for the identification of patients with persistent cerebral ischemia even after SACP.

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  • More enduring storage of information remains intact after brain silencing, as in barbiturate overdose or brain cooling.

    “The more enduring storage of information, however, remains intact after brain silencing.”

    From Synaptic memory and CaMKII (2023) · cites this paper as [6]

    The Results describe loss and restoration of EEG activity during circulatory arrest, but do not assess whether stored information survives that inactivity. The Comment raises a possible risk of neurocognitive deficits and calls for further study; it does not establish what happens to enduring memory storage. Searches for long-term memory storage and cognitive function after cooling found no passage resolving the claim. (LLM, conf=0.74)

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Research works printed but not linked: 26

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Cited by

Sorted by citations

Authors
Keenan, J. E., Wang, H., Ganapathi, A. M., Englum, B. R., Kale, E., Mathew, J. P., Husain, A. M., & Hughes, G. C.
Affiliations
  • Duke Medical Center (US)
  • Duke University (US)
Corresponding author
Hughes, G. Chad
ORCID
Venue
The Annals of Thoracic Surgery
Publisher
Elsevier BV
Published
2016-02
Volume
101
Issue
2
Pages
631-637
ISSN
0003-4975 (ISSN-L)
DOI
10.1016/j.athoracsur.2015.08.002
PMC
PMC5140096
OpenAlex
W1899065124
Cited by
29
References
0
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 2 · 2018: 5 · 2017: 3 · 2016: 3
FWCI
2.90
Type
journal article
Language
en
Open access
Licence
Locations
  • The Annals of Thoracic Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (5u01hl088953-05)
  • National Heart, Lung, and Blood Institute (UM1HL088953, U01-HL088953)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic aneurysm repair treatments
Keywords
intraoperative electroencephalography, moderate hypothermic circulatory arrest, selective antegrade cerebral perfusion, cerebral ischemia, burst suppression, cerebral reperfusion, cardiopulmonary bypass, aortic arch surgery
MeSH terms
Aged, Aortic Dissection, Cerebrovascular Circulation, Electroencephalography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Vascular Surgical Procedures, Monitoring, Intraoperative, Aortic Aneurysm, Thoracic, Stroke, Circulatory Arrest, Deep Hypothermia Induced

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