Abstract:
BACKGROUND:The probability of recovering consciousness in acute brain-injured patients depends on central nervous system damage and complications acquired during their stay in the intensive care unit. The objective of this study was to establish a relation between the Bispectral Index (BIS) and other variables derived from the analysis of the electroencephalographic signal, with the probability of recovering consciousness in patients in a coma state due to severe cerebral damage. METHODS:Twenty-five critically ill, unconscious brain-injured patients from whom sedative drugs were withdrawn at least 24 h before BIS recording were prospectively studied. BIS, 95% spectral edge frequency, burst suppression ratio, and frontal electromyography were recorded for 20 min. The neurologic condition of the patients was measured according to the Glasgow Coma Score (GCS). Patients were followed up for assessment of recovery of consciousness for 6 months after the injury. The studied variables were compared between the group of patients who recovered consciousness and those who did not recover. Their predictive ability was evaluated by means of the Pk statistic. Univariate and multivariate logistic regression was used to model the relation between variables and probability of recovery of consciousness. Cross-validation was used to validate the proposed model. RESULTS:There were statistically significant differences between the group of patients who recovered consciousness and those who did not with respect to BISmax, BISmin, BISmean, and BISrange, frontal electromyography, signal quality index values, and GCSBIS. The Pk (SE) values were 0.99 (0.01) for electromyelography, 0.96 (0.05) for BISmax, 0.92 (0.05) for BISmean, 0.92 (0.06) for BISrange, and 0.82 (0.09) for GCSBIS. The odds ratio for BISmax in the logistic regression model was 1.17 (95% confidence interval, 1.1-1.35). Cross-validation results reported a high-accuracy median absolute cross-validation performance error of 3.06% (95% confidence interval, 1-22.15%) and a low-bias median cross-validation performance error of 0.84% (0.56-2.12%). CONCLUSIONS:The study BIS and other electrophysiologic and clinical variables has enabled construction and cross-validation of a model relating BIS(max) to the probability of recovery of consciousness in patients in a coma state due to a severe brain injury, after sedation has been withdrawn.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Fàbregas N,Gambús PL,Valero R,Carrero EJ,Salvador L,Zavala E,Ferrer Edoi
10.1097/00000542-200407000-00009subject
Has Abstractpub_date
2004-07-01 00:00:00pages
43-51issue
1eissn
0003-3022issn
1528-1175pii
00000542-200407000-00009journal_volume
101pub_type
临床试验,杂志文章相关文献
ANESTHESIOLOGY文献大全abstract:BACKGROUND:The number of pregnancy-related deaths and severe maternal complications continues to rise in the United States, and the quality of obstetrical care across U.S. hospitals is uneven. Providing hospitals with performance feedback may help reduce the rates of severe complications in mothers and their newborns. ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002759
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Multicapillary column ion-mobility spectrometry (MCC-IMS) may identify volatile components in exhaled gas. The authors therefore used MCC-IMS to evaluate exhaled gas in a rat model of sepsis, inflammation, and hemorrhagic shock. METHODS:Male Sprague-Dawley rats were anesthetized and ventilated via tracheost...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000000420
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Ketamine is a commonly used anesthetic, but the mechanistic basis for its clinically relevant actions remains to be determined. The authors previously showed that HCN1 channels are inhibited by ketamine and demonstrated that global HCN1 knockout mice are twofold less sensitive to hypnotic actions of ketamine...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318287b7c8
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Optimal management of anesthesia-induced respiratory depression requires identification of the neural pathways that are most effective in maintaining breathing during anesthesia. Lesion studies point to the brainstem retrotrapezoid nucleus. We therefore examined the respiratory effects of common anesthetic/a...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002675
更新日期:2019-06-01 00:00:00
abstract::Thiopental was used in long-term infusion (3-4.5 mg . kg-1 . h-1 during 4-8 days) to protect the brain from injury following trauma. Thiopental plasma concentrations were measured during infusion (48 patients) and after infusion (14 patients) to determine the kinetics of the drug in continuous infusion. All mean value...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198507000-00007
更新日期:1985-07-01 00:00:00
abstract:BACKGROUND:Breastfeeding is an important public health concern. High cumulative doses of epidural fentanyl administered for labor analgesia have been reported to be associated with early termination of breastfeeding. We tested the hypothesis that breastfeeding success is adversely influenced by the cumulative epidural ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0000000000001793
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Chronic neck pain after whiplash injury is caused by cervical zygapophysial joints in 50% of patients. Diagnostic blocks of nerves supplying the joints are performed using fluoroscopy. The authors' hypothesis was that the third occipital nerve can be visualized and blocked with use of an ultrasound-guided te...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/00000542-200602000-00016
更新日期:2006-02-01 00:00:00
abstract::Decreased urinary output (Vu ml/min) after institution of PEEP is attributed to a variety of mechanisms including decreased cardiac output and renal blood flow (RBF), activation of neurohormonal reflexes, increased catecholamines, plasma renin activity (PRA), and antidiuretic hormone (ADH) release. To evaluate these f...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198701000-00004
更新日期:1987-01-01 00:00:00
abstract::Analgesia is an important component of general anesthesia. alpha 2-adrenoceptor agonists such as clonidine and dexmedetomidine are effective analgesics at the spinal level, and furthermore, they reduce the volatile anesthetic requirement. In order to probe a possible spinal-level contribution to general anesthetic-ind...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199109000-00017
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Acid-sensing ion channel 3 (ASIC3) upregulation has been reported in dorsal root ganglion neurons after incision and contributes to postoperative nociception. This study hypothesized that upregulation of ASIC3 in incised tissues is induced by nerve growth factor through the phosphoinositide 3-kinase/protein ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000003576
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Alveolar overdistension and repetitive derecruitment-recruitment contribute to ventilator-induced lung injury (VILI). The authors investigated (1) whether inflammatory cell activation due to VILI was assessable by positron emission tomography and (2) whether cell activation due to dynamic overdistension alon...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/01.anes.0000264748.86145.ac
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:The pharmacokinetics of epidurally administered drugs has been the subject of many studies, yet drug concentration in the epidural space has never been measured. This study was undertaken to characterize the epidural, cerebrospinal fluid, and plasma pharmacokinetics of epidurally administered opioids on the ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200308000-00029
更新日期:2003-08-01 00:00:00
abstract::This study was performed to determine the potency of succinylcholine using the single-dose technique, and to test the ability of the cumulative dose technique for generating dose-response data. Thirty-eight adult patients received single doses (n = 18), cumulative doses (n = 10), or cumulative doses of succinylcholine...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract:BACKGROUND:The spinal delivery of the cholinesterase inhibitor neostigmine yields analgesia in rats and augments the analgesic effects of alpha 2 agonists in sheep. To assess its activity in humans, preclinical toxicology studies to define its safety were required in two species. METHODS:Rats with chronic intrathecal ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199502000-00012
更新日期:1995-02-01 00:00:00
abstract::The purpose of this study was to evaluate the analgesic contribution of intravenously administered lidocaine and to correlate it with blood levels of the drug. In a double-blind manner, 14 healthy male volunteers received saline solution or lidocaine, 0.2 per cent, at three increasingly greater rates of infusion on tw...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198001000-00005
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Awake tracheal intubation may evoke reflex bronchoconstriction in asthmatics. Whether this effect is altered by the choice of the local anesthetic used or by pretreatment with a beta2-adrenoceptor agonist is unknown. Therefore, we assessed the effect of awake fiberoptic intubation after lidocaine or dyclonin...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200212000-00016
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:To compare continuous cardiac output obtained by simulation of an aortic input impedance model to bolus injection thermodilution (TDCO) in critically ill patients with septic shock. METHODS:In an open study, mechanically ventilated patients with septic shock were monitored for 1 (32 patients), 2 (15 patient...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199905000-00016
更新日期:1999-05-01 00:00:00
abstract::Oral transmucosal fentanyl citrate (OTFC) is a novel, noninvasive dosage form of fentanyl used to provide children and adults with sedation, anxiolysis, and analgesia. In order to determine the bioavailability and absorption of fentanyl from OTFC, 12 volunteers were given intravenous fentanyl citrate or OTFC 15 microg...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-199108000-00009
更新日期:1991-08-01 00:00:00
abstract:BACKGROUND:Good postoperative recovery is increasingly recognized as an important outcome after surgery. The authors created a new Post-operative Quality Recovery Scale (PQRS) that tracks multiple domains of recovery from immediate to long-term time periods in patients of varying ages, languages, and cultures. METHODS...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181d960a9
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Identifying functionally relevant anesthetic-binding sites in pentameric ligand-gated ion channels (pLGICs) is an important step toward understanding the molecular mechanisms underlying anesthetic action. The anesthetic propofol is known to inhibit cation-conducting pLGICs, including a prokaryotic pLGIC from...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000001005
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Lamotrigine inhibits glutamate release through the preferential blockade of voltage-dependent Na+ channels. In contrast, morphine reduces release of excitatory amino acids through the activation of opioid receptors and also inhibits tetrodotoxin-resistant Na+ channels on peripheral afferent neurons. The curr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200204000-00020
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Patient-controlled analgesia (PCA) with intravenous morphine and patient-controlled epidural analgesia (PCEA), using an opioid either alone or in combination with a local anesthetic, are two major advances in the management of pain after major surgery. However, these techniques have been evaluated poorly in ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200002000-00025
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND:Factor VII is the most affected clotting factor during the early phase of warfarin therapy. An international normalized ratio (INR) of more than 1.4 is considered unsafe for epidural catheter placement or removal, according to the American Society of Regional Anesthesia and Pain Medicine. The authors tested ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181ca6cfc
更新日期:2010-02-01 00:00:00
abstract:INTRODUCTION:Directional connectivity from anterior to posterior brain regions (or "feedback" connectivity) has been shown to be inhibited by propofol and sevoflurane. In this study the authors tested the hypothesis that ketamine would also inhibit cortical feedback connectivity in frontoparietal networks. METHODS:Sur...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e31829103f5
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Rapid development of acute opioid tolerance is well established in animals and is more likely to occur with large doses of short-acting drugs. The authors therefore tested the hypothesis that intraoperative remifentanil administration results in acute opioid tolerance that is manifested by increased postoper...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200008000-00019
更新日期:2000-08-01 00:00:00
abstract::Reversal of the usual relationship between aortic and radial artery pressure can occur in patients following cardiopulmonary bypass. Radial systolic (and often radial mean) pressures were lower, relative to aortic pressure, after cardiopulmonary bypass than before bypass in all 18 patients studied. The systolic pressu...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198505000-00002
更新日期:1985-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate a new, physiologically inspired method for the analysis of the electroencephalogram during propofol-remifentanil anesthesia. Based on fixed-order autoregressive moving-average modeling, this method was hypothesized to be capable of dissociating the effects that hypno...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181e3d8a6
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Whether the fetus can experience pain remains controversial. During the last half of pregnancy, the neuroanatomic connections for nociception are in place, and the human fetus mounts sizable stress responses to physical insults. Analgesia has been recommended for intrauterine procedures or late termination, ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200110000-00008
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:The abundance of a specific sodium channel subunit (SkM2) appeared to be altered in vitro in cell cultures from persons susceptible to malignant hyperthermia. This study sought to determine whether these findings are artifacts of cell culture or whether they may be relevant to malignant hyperthermia. METHOD...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199705000-00004
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Insufficient data exist on the production of compound A during closed-system sevoflurane administration with newer carbon dioxide absorbents. METHODS:A modified PhysioFlex apparatus (Dräger, Lübeck, Germany) was connected to an artificial test lung (inflow at the top of the bellow approximately/= 160 ml/min...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200109000-00030
更新日期:2001-09-01 00:00:00