Transcranial doppler, EEG and SEP monitoring

The role of neuromonitoring in the prevention of cerebral damage associated with cardiosurgical interventions has not yet been clearly elucidated. Reliable randomised studies from evidence-based medicine showing a clear reduction of risk do not exist. Numerous studies and reviews however, have confirmed that non-invasive procedures for monitoring neuronal or neurophysiological changes before, during and after interventions within the heart or the major thoracic vessels are available and provide early indications of damage. Technological modalities and clinical indications for non invasive cerebral monitoring were evaluated: - Electroencephalography (EEG) with processed EEG, bispectral index (BIS) and the evoked potential for use with spinal cord function - Near infrared spectroscopy (NIRS) for assessment of cerebral perfusion and oxygenation - Transcranial Doppler sonography (TCDS) for assessment of cerebral circulation and perfusion - Multimodality monitoring as a combination of EEG, NIRS and TCDS.