Evidence map›Paper›PMID 25572653›Full record

Observational studyJournal of clinical monitoring and computing2015

Cerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia.

William Perez, Christopher Dukatz, Sami El-Dalati, James Duncan, Mahmoud Abdel-Rasoul, Andrew Springer, Michael R Go, Roger Dzwonczyk

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of clinical monitoring and computing, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 20 citations in OpenAlex.

  1. Observational
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

William PerezDepartment of Anesthesiology, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH, 43210, USA. william.perez@osumc.edu.
Christopher DukatzCollege of Medicine, The Ohio State University, 370 West 9th Avenue, Columbus, OH, 43210, USA. christopher.dukatz@osumc.edu.
Sami El-DalatiCollege of Medicine, The Ohio State University, 370 West 9th Avenue, Columbus, OH, 43210, USA. sami.el-dalati@osumc.edu.
James DuncanCollege of Medicine, The Ohio State University, 370 West 9th Avenue, Columbus, OH, 43210, USA. james.duncan@osumc.edu.
Mahmoud Abdel-RasoulCenter for Biostatistics, The Ohio State University, 2012 Kenny Road, Columbus, OH, 43221, USA. mahmoud.abdel-rasoul@osumc.edu.
Andrew SpringerDepartment of Anesthesiology, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH, 43210, USA. andrew.springer@osumc.edu.
Michael R GoDepartment of Vascular Surgery, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH, 43210, USA. michael.go@osumc.edu.
Roger DzwonczykDepartment of Anesthesiology, The Ohio State University Wexner Medical Center, 410 West 10th Avenue, Columbus, OH, 43210, USA. dzwonczyk.1@osu.edu.
The Ohio State University Wexner Medical Center · USThe Ohio State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation (rSO2) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO2 and processed EEG monitor. The response of the monitors during carotid artery clamping and shunting were assessed and compared between monitors and bilaterally within each monitor. Sixty-nine patients were included in the study. At clamping the surgical-side and contralateral-side rSO2 dropped significantly below the baseline incision value (-17.6 and -9.4% respectively). After shunting, the contralateral-side rSO2 returned to baseline while the surgical-side rSO2 remained significantly below baseline (-9.0%) until the shunt was removed following surgery. At clamping the surgical-side and contralateral-side processed EEG also dropped below baseline (-19.9 and -20.6% respectively). However, following shunt activation, the processed EEG returned bilaterally to baseline. During the course of this research, we found the rSO2 monitor to be clinically more robust (4.4% failure rate) than the processed EEG monitor (20.0% failure rate). There was no correlation between the rSO2 or processed EEG changes that occurred immediately after clamping and the degree of surgical side stenosis measured pre-operatively. Both rSO2 and processed EEG respond to clamping and shunting during CEA. Cerebral oximetry discriminates between the surgical and contralateral side during surgery. The rSO2 monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these monitors that can predict clamping-induced cerebral ischemia during CEA in order to decide whether carotid artery shunting is worth the associated risks. From the practical point of view, the rSO2 monitor may be the better monitor for this purpose.

Indexed as

ElectroencephalographyEndarterectomy, CarotidAnesthesia, GeneralBrain IschemiaCerebrovascular CirculationConstrictionHumansMonitoring, IntraoperativeOximetryOxygenProspective StudiesOxygenCarotid endarterectomyCerebral blood flowCerebral ischemiaCerebral oximetryNIRSProcessed EEG

Identifiers

PMID25572653
OpenAlexW2037987565

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.