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Compressed Spectral Array를 이용한 뇌허혈 증상에 대한 뇌보호방법 정립에 관한 임상실험

Other Titles
 The Clinical Experiement to Develop the Brain Protection Protocol in Cerebral Ischemia Using Compressed Spectral Array 
 민경태  ;  김선호  ;  김종훈  ;  이배환  ;  박성용  ;  박은경  ;  이규창 
 Journal of Korean Neurosurgical Society (대한신경외과학회지), Vol.32(4) : 341-352, 2002 
Journal Title
Journal of Korean Neurosurgical Society(대한신경외과학회지)
Issue Date
Cerebral protection ; Carotid endarterectomy ; Aneurysm surgery ; Thiopental ; Hypothermia ; Temporary clipping
Objective: The clinical experiment to establish the cerebral protection protocol for hemodynamically vulnerable patients from ischemic insult during surgery is presented.

Methods: The experiment divided in two parts, one is to analyze the effect of intravenous anesthetics and inhalation anesthetics on EEG activity in neurologically intact 81 patients. The others is to develop the stepwise cerebral protection protocol during aneurysm surgery which required temporary clipping, carotid endarterectomy and extracranial intracranial arterial bypass surgery in 61 patients. The cerebral protection protocol included the use of intraoperative compressed spectral array(CSA) monitoring, induced hypertension, thiopental induced burst suppression and moderate hypothermia.

Results: With the efforts of brain protection protocol, 59 of the 61 patients recovered without any newly developed neurological deficit from the surgery. One patient had carotid stenosis with multiple untreated aneurysms, and therefore, induced hypertension was not applied. This patient developed significant postoperative neurological deficits correlated well with the CSA changes. In one patient who has cerebral aneurysm, thiopental bolus injection was used. This patient has reduction
of EEG activity during temporary clipping and developed the relatively well correlated neurologic deficit postoperatively. Among 28 carotid endarterectomy cases, three patients has definite reduction of EEG activities within 7 to 15 seconds of interval carotid
artery(ICA) test clamping before endarterectomy. But, these patients recovered from surgery without any neurological deficit inspite of 28 to 35 minutes ICA clamping with the effort of thiopental induced burst suppression, induced hypertension and moderate hypothermia.

Conclusion: Cerebral protection protocol under CSA monitoring could prevent ischemic insults from circulatory disruption on vulnerable ischemic hemisphere.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Physiology (생리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sun Ho(김선호) ORCID logo https://orcid.org/0000-0003-0970-3848
Kim, Jong Hoon(김종훈)
Min, Kyeong Tae(민경태) ORCID logo https://orcid.org/0000-0002-3299-4500
Park, Eun Kyung(박은경)
Lee, Kyu Chang(이규창)
Lee, Bae Hwan(이배환) ORCID logo https://orcid.org/0000-0003-4719-9021
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