与心外膜起搏相关的异常高患者状态指数：一例报告。
Abnormally high Patient State Index associated with epicardial pacing: a case report.
作者信息
Yonezawa Hiroki, Maeda Takuma, Takise Yoshiaki, Morinaga Masahiro, Ohnishi Yoshihiko
机构信息
Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan.
出版信息
JA Clin Rep. 2022 May 20;8(1):35. doi: 10.1186/s40981-022-00521-8.
BACKGROUND
Anesthesiologists monitor electroencephalography (EEG) intraoperatively to maintain adequate depth of anesthesia. However, the EEG signal is affected by noise and interference. The SedLine® is a brain function monitor with which the Patient State Index (PSI) is calculated. In this study, we report abnormally high PSI values associated with epicardial pacing during open heart surgery.
CASE PRESENTATION
A 50-year-old man was scheduled for total arch replacement. Atrial demand pacing was started before weaning from cardiopulmonary bypass. The PSI increased from 30 to 80 soon after the start of pacing, and the EEG waveform showed spikes synchronized with the pacing. As the pacing output was lowered, the spikes on the EEG attenuated and disappeared, and the PSI decreased to < 40. When the pacing output was increased again, the spikes recurred, and the PSI increased again.
CONCLUSIONS
Pacemaker spikes may cause contamination of the EEG, resulting in abnormally high PSI values.
背景
麻醉医生在手术中监测脑电图（EEG）以维持适当的麻醉深度。然而，EEG信号会受到噪声和干扰的影响。SedLine®是一种脑功能监测仪，可据此计算患者状态指数（PSI）。在本研究中，我们报告了心脏直视手术期间与心外膜起搏相关的异常高PSI值。
病例介绍
一名50岁男性计划进行全弓置换术。在脱离体外循环前开始心房按需起搏。起搏开始后不久，PSI从30增加到80，EEG波形显示与起搏同步的尖峰。随着起搏输出降低，EEG上的尖峰减弱并消失，PSI降至<40。当起搏输出再次增加时，尖峰再次出现，PSI再次升高。
结论
起搏器尖峰可能导致EEG污染，导致PSI值异常升高。
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