Quantitative electroencephalography: A method to assess cerebral injury after hypothermic circulatory arrest Craig K. Mezrow, MSa (by invitation), Peter.

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Quantitative electroencephalography: A method to assess cerebral injury after hypothermic circulatory arrest Craig K. Mezrow, MSa (by invitation), Peter S. Midulla, MDa(by invitation), Ali M. Sadeghi, MDa(by invitation), Alejandro Gandsas, MDa(by invitation), Weijia Wang, MDb(by invitation), Howard H. Shiang, DVMa(by invitation), Carol Bodian, PhDc(by invitation), Otto E. Dapunt, MDa(by invitation), Rosario Zappulla, MD, PhDb(by invitation), Randall B. Griepp, MD The Journal of Thoracic and Cardiovascular Surgery Volume 109, Issue 5, Pages 925-934 (May 1995) DOI: 10.1016/S0022-5223(95)70318-7 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Percent EEG silence for the four experimental groups: at the end of cooling, at 30° C (during rewarming), and at 2 hours after the start of rewarming. As EEG is discontinuous at these time points, groups are compared based on the basis of the percent of EEG silence. A higher percent silence is equivalent to lower EEG power with continuous EEG data. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Percent of baseline quantitative EEG 2 hours after the start of rewarming. The graph depicts the average power for each experimental group for each of the 20 frequency bands (1 to 20). The LFCPB and control groups are closely intertwined and show a greater degree of EEG recovery than either of the HCA groups at every frequency band. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Number of frequency bands significantly different from baseline at 2, 4, and 8 hours after rewarming. This is a more quantitative comparison of the recovery of EEG power: the more bands significantly different from baseline, the worse the recovery of EEG power. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 4 Intraoperative QEEG differences between the groups at the 2-hour measurement. This intergroup comparison demonstrates the number of frequency bands that are significantly different between the groups. There are a far greater number of bands that are significantly different between the 90 min HCA group and both control and LFCPB groups than between 90 min HCA and 30 min HCA groups. The 30 min HCA group is also significantly different from both the control and the LFCPB groups, but not for as many bands. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 5 Intraoperative QEEG differences between groups at the 4-hour measurement. As in Fig. 4, there remains a large difference between the 90 min HCA and control and LFCPB groups and a smaller difference between 90 min HCA and 30 min HCA groups. There remains a difference between 30 min HCA and control groups. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 6 Intraoperative QEEG differences between groups at the 8-hour measurement. At 8 hours there is a clear difference in EEG power between the 90 min HCA group and all others. By this late time point, there are no differences between the 30 min HCA or the LFCPB and the control groups. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 7 Neurologic/behavioral score versus EEG power at the 2-hour measurement. EEG power of less than 500 μ V 2 at this time point was associated with later overt neurologic impairment. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 8 Changes in relative EEG power (percent of shift to lower frequencies): preoperative versus postoperative values. Significant differences were found in the parietal leads between the 90 min HCA group and both the control group and the LFCPB group. Differences in the frontal leads were not statistically significant. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 925-934DOI: (10.1016/S0022-5223(95)70318-7) Copyright © 1995 Mosby, Inc. Terms and Conditions