Perioperative cerebral ischaemia in cardiac surgery and BIS.
A 46-year-old woman was monitored by bispectral index monitoring (BIS) during redo aortic and mitral valve replacement. On release of the aortic cross clamp there was a sudden, severe, unexplained, and sustained fall in the BIS value. Postoperatively, a CT scan was consistent with multiple ischaemic lesions. The lesions were presumed to be due to air embolism. This case suggests that a sudden unexplained and persistent fall in BIS may indicate cerebral ischaemia.
Villacorta
J
J
Department of Anesthesiology and Intensive Care, Groupe Hospitalier Timone, Marseilles, France.
Kerbaul
F
F
Collart
F
F
Guidon
C
C
Bonnet
M
M
Guillen
J C
JC
Gouin
F
F
D001921:Brain / Q000000981:diagnostic imaging; D001929:Brain Edema / Q000175:diagnosis / Q000209:etiology; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D004569:Electroencephalography / Q000379:methods*; D004618:Embolism, Air; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods