Cerebral Monitoring in the Operating Room and the Intensive Care Unit

1. Front Matter

   Pages I-X

   PDF

2. Introduction

   • Enno Freye

   Pages 1-5

3. The principle of EEG recording using computerized power spectral analysis

   • Enno Freye

   Pages 6-20

4. Set-up of monitoring the EEG

   • Enno Freye

   Pages 21-24

5. Anesthesia and the EEG

   • Enno Freye

   Pages 25-36

6. The EEG and cerebral ischemia

   • Enno Freye

   Pages 37-46

7. Cerebral monitoring in the intensive care unit

   • Enno Freye

   Pages 47-63

8. Trouble shooting

   • Enno Freye

   Pages 64-67

9. Systems currently available for processed EEG recording

   • Enno Freye

   Pages 68-83

10. Sensory Evoked Potentials

    • Enno Freye

    Pages 84-87

11. The principle of Somatosensory Evoked Potential Monitoring

    • Enno Freye

    Pages 88-103

12. Optimising signal-to-noise ratio

    • Enno Freye

    Pages 104-112

13. Evaluating the response of the evoked potential

    • Enno Freye

    Pages 113-121

14. The effect of drugs on the evoked potential

    • Enno Freye

    Pages 122-129

15. Use of evoked potentials in the ICU

    • Enno Freye

    Pages 130-144

16. Auditory Evoked Potentials (AEPs) and Brainstem Auditory Evoked Responses (BAER or BAEP)

    • Enno Freye

    Pages 145-150

17. Visual Evoked Potentials (VEPs)

    • Enno Freye

    Pages 151-155

18. Complications that arise during EP monitoring

    • Enno Freye

    Pages 156-157

19. Systems of use for EP measurements in the OR and in the ICU

    • Enno Freye

    Pages 158-177

20. New scopes in cerebral monitoring by topographic mapping of EEG-power spectra and EP waves

    • Enno Freye

    Pages 178-181

In spite of today's increasing body of knowledge in regard to central nervous func­ tion and/or the mode of action of centrally active compounds, little is done to monitor those patients which are at risk of cerebral lesions either in the OR or in the ICU. Due to the inconsistency of reports regarding the application and the benefits computerized EEG and/or evoked potential monitoring will bring to the clinician, physicians still are reluctant to get involved with a technique, which they think, will have little or no effect on the outcome of a patients well being. However, due to the development in computer technology, data acquisition and comprehension, it now is possible to monitor such a viable organ as the Central Nervous System (CNS) on a routine base without being a specialist in neurology or electroencephalography. Thus, the book is intended to guide the clinician to use BEG and evoked potential monitoring in a day to day situation, without going too deep into technical details. As an improvement of cerebral care is needed, various representative cases underline the interpretation of EEG power spectra and evoked potential changes in regard to the underlying clinical situation. It is hoped that this book will serve as a guide to anyone who considers cerebral monitoring a necessity in today's patient care. This may be the anesthesiologist, the intensive care therapist, the nurse anesthetist as well as the medical personnel in the lCU setting.

• Trauma
• brain
• brainstem
• care
• cerebral ischemia
• clinical application
• complications
• electroencephalography (EEG)
• intensive care
• intensive care unit
• visual evoked potential (VEP)

• Department of Vascular Surgery and Renal Transplantation, Heinrich Heine University of Düsseldorf, Germany

  Enno Freye

• Department of Central Diagnostics, Rheinische Landes- und Hochschulklinik in the University Clinics of Essen, Germany

  Enno Freye

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