Azuma Seiichi, Asamoto Masaaki, Akabane Shinichi, Ezaka Mariko, Otsuji Mikiya, Uchida Kanji
Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan.
Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Clin Monit Comput. 2025 Mar 6. doi: 10.1007/s10877-025-01272-4.
Electroencephalogram-derived monitors are affected by various artifacts. HeartMate 3™ operates at frequency bands that overlap with those used for calculating the electromyographic index (EMG) and bispectral index (BIS) on the Bispectral Index™ monitor. This study investigated whether HeartMate 3 elevates these values, a change not predicted with HeartMate II™. This retrospective observational study included data from patients who underwent HeartMate 3 or II implantation between April 2008 and December 2023 as extracted from our institutional database. Patient-wise median EMG and BIS were compared between the pre-LVAD period (from the start of surgery to initiation of cardiopulmonary bypass) and the post-LVAD period (from the end of cardiopulmonary bypass to end of surgery). Data were obtained from 33 and 43 patients who underwent HeartMate 3 and HeartMate II implantation, respectively. Patients with HeartMate 3 implantation showed significant elevation in the EMG (pre-LVAD, mean ± standard deviation, 26.1 ± 1.0 dB; post-LVAD, 39.5 ± 2.8 dB; P < 0.001) without a significant change in the BIS (pre-LVAD, 44.5 ± 8.1; post-LVAD, 45.5 ± 7.1; P = 0.35). In contrast, patients with HeartMate II implantation did not show significant changes in either the EMG (pre-LVAD, 26.1 ± 1.2 dB; post-LVAD, 27.1 ± 4.1 dB; P = 0.16) or BIS (pre-LVAD, 45.1 ± 9.2; post-LVAD, 43.0 ± 8.1; P = 0.071). HeartMate 3 significantly elevates EMG. Anesthesiologists should be aware of this to appropriately interpret EMG elevation in patients with HeartMate 3.Trial registration: Japan Registry for Clinical Trials identifier: jRCT1030230549 (date of registration: January 10, 2024.
脑电图衍生监测仪会受到各种伪迹的影响。HeartMate 3™ 的工作频段与用于计算双谱指数监测仪上的肌电图指数（EMG）和双谱指数（BIS）的频段重叠。本研究调查了 HeartMate 3 是否会升高这些值，这一变化在 HeartMate II™ 中未被预测到。这项回顾性观察研究纳入了 2008 年 4 月至 2023 年 12 月期间在我们机构数据库中提取的接受 HeartMate 3 或 II 植入的患者数据。比较了左心室辅助装置（LVAD）植入前（从手术开始到体外循环启动）和 LVAD 植入后（从体外循环结束到手术结束）患者个体的 EMG 和 BIS 中位数。分别从 33 例和 43 例接受 HeartMate 3 和 HeartMate II 植入的患者中获取数据。植入 HeartMate 3 的患者 EMG 显著升高（LVAD 植入前，平均值±标准差，26.1±1.0dB；LVAD 植入后，39.5±2.8dB；P＜0.001），而 BIS 无显著变化（LVAD 植入前，44.5±8.1；LVAD 植入后，45.5±7.1；P = 0.35）。相比之下，植入 HeartMate II 的患者 EMG（LVAD 植入前，26.1±1.2dB；LVAD 植入后，27.1±4.1dB；P = 0.16）和 BIS（LVAD 植入前，45.1±9.2；LVAD 植入后，43.0±8.1；P = 0.071）均无显著变化。HeartMate 3 显著升高 EMG。麻醉医生应意识到这一点，以便在 HeartMate 3 患者中正确解读 EMG 升高情况。试验注册：日本临床试验注册标识符：jRCT1030230549（注册日期：2024 年 1 月 10 日）
