Processed electroencephalogram during donation after cardiac death.
We present a case series of increased bispectral index values during donation after cardiac death (DCD). During the DCD process, a patient was monitored with processed electroencephalogram (EEG), which showed considerable changes traditionally associated with lighter planes of anesthesia immediately after withdrawal of care. Subsequently, to validate the findings of this case, processed EEG was recorded during 2 other cases in which care was withdrawn without the use of hypnotic or anesthetic drugs. We found that changes in processed EEG immediately after withdrawal of care were not only reproducible, but can happen in the absence of changes in major electromyographic or electrocardiographic artifact. It is well documented that processed EEG is prone to artifacts. However, in the setting of DCD, these changes in processed EEG deserve some consideration. If these changes are not due to artifact, dosing of hypnotic or anesthetic drugs might be warranted. Use of these drugs during DCD based primarily on processed EEG values has never been addressed.
Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA 98101, USA. david.auyong@vmmc.org
David B
DB
Auyong
Stephen M
SM
Klein
Tong J
TJ
Gan
Anthony M
AM
Roche
Daiwai
D
Olson
Ashraf S
AS
Habib
D000368:Aged; D001281:Atrial Fibrillation; D001926:Brain Death; D002423:Cause of Death; D002543:Cerebral Hemorrhage / Q000473:pathology; D003071:Cognition / Q000502:physiology; D003643:Death; D003657:Decision Making; D004562:Electrocardiography; D004569:Electroencephalography; D004576:Electromyography; D015600:Glasgow Coma Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D016377:Organ Transplantation / Q000941:ethics*; D015203:Reproducibility of Results; D013345:Subarachnoid Hemorrhage / Q000473:pathology; D014019:Tissue Donors