MULTIMODAL NEUROMONITORING IN CARDIAC SURGERY: FOCUS ON ELECTROENCEPHALOGRAPHY

Neurological complications after cardiac surgery, ranging from temporary cognitive issues to severe strokes, are a major concern, especially for elderly patients. Many in­dividuals over 70 already have a history of neurological conditions, which increases their risk of complications and long-term effects. Serious neurological events, such as strokes, occur in up to 6% of cardiac surgery patients. Given the vulnerability of these patients, prevention is crucial.

Several factors can contribute to neurological damage du­ring surgery, including embolism, inflammation, anemia, and arterial disease, however hypoperfusion is usually the main cause. Over the years, various systems have been developed to monitor brain oxygen levels and help doctors maintain proper cerebral perfusion. Neuromoni­toring during cardiac surgery utilizes multiple techniques to assess cerebral perfusion and oxygenation, such as near infrared spectroscopy, transcranial Doppler, and jugular venous bulb saturation monitoring – as well as cerebral function, monitored through both processed and raw electroencephalography. Electroencephalography in cardiac surgery is used to assess cerebral function, depth of anesthesia, and detect signs of neurological damage. It can help guide anesthetic management, ensuring adequ­ate brain protection during surgery.