title: Detection of cerebral hypoperfusion with bispectral index during paediatric cardiac surgery.
abstract: BACKGROUND
  The bispectral index (BIS) may indicate changes in cerebral activity when the cerebral circulation is affected by acute hypotension.
  
  
  METHODS
  We measured BIS and cerebral haemoglobin saturation (Sr(O(2))) by near-infrared spectroscopy in 10 children undergoing cardiac surgery.
  
  
  RESULTS
  We noted 14 episodes of simultaneous decreases in Sr(O(2)) and BIS during acute hypotension in five children. An acute decrease in BIS, which coincided with a decrease in Sr(O(2)) suggesting a reduction in cerebral blood flow, was associated with acute slowing of the raw EEG waveforms.
  
  
  CONCLUSIONS
  Our findings suggest that an acute decrease in BIS during acute hypotension indicates cerebral hypoperfusion, and that cerebral hypoperfusion caused by hypotension may occur frequently during paediatric cardiac surgery.
authors.affiliation: Department of Anaesthesiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Japan. hayashida-todai@umin.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Hayashida
authors.forename: M
authors.initials: M
authors.lastname: Chinzei
authors.forename: K
authors.initials: K
authors.lastname: Komatsu
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: H
authors.initials: H
authors.lastname: Tamai
authors.forename: R
authors.initials: R
authors.lastname: Orii
authors.forename: K
authors.initials: K
authors.lastname: Hanaoka
authors.forename: A
authors.initials: A
authors.lastname: Murakami
mesh_terms: D001794:Blood Pressure; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007022:Hypotension / Q000150:complications; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D010100:Oxygen / Q000097:blood; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen