[The artificial heart and neuromonitoring? Technical and clinical aspects].
There is a steady progress in the development of artificial heart and circulatory assist devices. There is also no doubt that further advances in energy systems, materials, and electronics will provide for smaller and more reliable electrically driven blood pumps, but the present engineering design appears to be adequate to provide devices satisfactory for initial clinical use. Due to problems in the availability of suitable donor hearts, the concept of replacing the natural heart with an artificial heart as a "bridge to transplantation" has gained attention in recent years. The present paper shows technical and clinical aspects of multivariable electrophysiologic neuromonitoring in a patient with an artificial heart assist device in the intensive care unit. The data (EEG, 40 Hz brain oscillations, brainstem auditory- and somatosensory evoked potentials) are discussed with respect to the influence of the artificial heart on their quality and reliability. Reasons for artifacts and problems of interpretation are shown.
AG Biomedizinische Technik, Universitätsklinik für Anästhesiologie und Intensivmedizin Graz.
G
G
Litscher
G
G
Schwarz
E
E
Eger
I
I
Hadolt
E
E
Mahla
K H
KH
Tscheliessnigg
D016477:Artifacts; D001933:Brain Stem / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D003422:Critical Care; D004569:Electroencephalography / Q000295:instrumentation*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005583:Fourier Analysis; D006354:Heart, Artificial; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*