Diving Medical Center, Royal Netherlands Navy, Den Helder, The Netherlands.
Clin Neurophysiol. 2012 Feb;123(2):411-7. doi: 10.1016/j.clinph.2011.06.028. Epub 2011 Jul 28.
Cerebral arterial gas embolism (CAGE) is a serious hazard in cardiovascular surgery and other invasive procedures. We used a swine model of CAGE to determine if quantitative electroencephalography (qEEG) is a useful tool in diagnosis and prognostication of CAGE.
0.05 ml/kg of air was injected into the ascending pharyngeal artery in 16 pigs. Intracranial pressure, lactate in brain microdialysate and brain oxygen tension were measured during 4h after embolization. The qEEG parameters mean amplitude (MAMP), alpha-delta ratio (ADR), spectral edge frequency (SEF(90)), spatial brain symmetry index (sBSI) and temporal brain symmetry index (tBSI) were calculated.
MAMP and tBSI but not ADR, SEF(90) and sBSI correlate with intracranial pressure, brain lactate and brain oxygen tension after 4h. Early levels of MAMP and tBSI can predict intracranial pressure, brain lactate and brain oxygen tension after 4h.
MAMP and tBSI are sensitive for cerebral injury and can predict outcome in a swine model of CAGE.
This study provides evidence for the utility of qEEG for diagnosis and prognosis in CAGE. Further studies are necessary to investigate the use of this method in patients.
脑动脉气体栓塞（CAGE）是心血管手术和其他有创操作中的严重危害。我们使用猪的 CAGE 模型来确定定量脑电图（qEEG）是否是诊断和预测 CAGE 的有用工具。
在 16 头猪中，将 0.05ml/kg 的空气注入咽升动脉。栓塞后 4 小时内测量颅内压、脑微透析液中的乳酸和脑氧张力。计算 qEEG 参数平均幅度（MAMP）、α-δ 比（ADR）、频谱边缘频率（SEF(90)）、空间脑对称指数（sBSI）和时间脑对称指数（tBSI）。
MAMP 和 tBSI 与颅内压、脑乳酸和脑氧张力相关，但 ADR、SEF(90)和 sBSI 不相关。MAMP 和 tBSI 的早期水平可以预测 4 小时后的颅内压、脑乳酸和脑氧张力。
MAMP 和 tBSI 对脑损伤敏感，并能预测 CAGE 猪模型的预后。
本研究为 qEEG 在 CAGE 的诊断和预后中的应用提供了证据。需要进一步研究来探讨该方法在患者中的应用。
