Kortelainen, J., Väyrynen, E., Huuskonen, U., Laurila, J., Koskenkari, J., Backman, J. T., … Ala-Kokko, T. (2017). Pilot Study of Propofol-induced Slow Waves as a Pharmacologic Test for Brain Dysfunction after Brain Injury. Anesthesiology, 126(1), 94–103. https://doi.org/10.1097/aln.0000000000001385
Pilot study of propofol-induced slow waves as a pharmacologic test for brain dysfunction after brain injury
|Author:||Kortelainen, Jukka1; Väyrynen, Eero1; Huuskonen, Usko2;|
1Physiological Signal Analysis Team, Center for Machine Vision and Signal Analysis, Medical Research Center Oulu
2Department of Clinical Neurophysiology, Medical Research Center Oulu
3Unit of Surgery, Anaesthesia and Intensive Care, Medical Faculty
4University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Department of Anaesthesiology, Medical Research Center Oulu
|Online Access:||PDF Full Text (PDF, 1.5 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019090627015
|Publish Date:|| 2019-09-06
Background: Slow waves (< 1 Hz) are the most important electroencephalogram signatures of non-rapid eye movement sleep. While considered to have a substantial importance in, for example, providing conditions for single-cell rest and preventing long-term neural damage, a disturbance in this neurophysiological phenomenon is a potential indicator of brain dysfunction.
Methods: Since, in healthy individuals, slow waves can be induced with anesthetics, we tested the possible association between hypoxic brain injury and slow wave activity in comatose post-cardiac arrest patients (N = 10) using controlled propofol exposure. The slow wave activity was determined by calculating the low-frequency (< 1 Hz) power of the electroencephalograms recorded approximately 48 h after cardiac arrest. To define the association between the slow waves and the potential brain injury, the patients’ neurological recovery was then followed for six months.
Results: In the patients with good neurological outcome (N = 6), the low-frequency power of electroencephalogram representing the slow wave activity was found to substantially increase (190 ± 83%, mean ± SD) due to the administration of propofol. By contrast, the patients with poor neurological outcome (N = 4) were unable to generate propofol-induced slow waves.
Conclusions: In this experimental pilot study, the comatose post-cardiac arrest patients with poor neurological outcome were unable to generate normal propofol-induced electroencephalographic slow wave activity 48 h after cardiac arrest. The finding might offer potential for developing a pharmacological test for prognostication of brain injury by measuring the electroencephalographic response to propofol.
|Pages:||94 - 103|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
217 Medical engineering
This work was financially supported by grant 40273/14 from Tekes - Finnish Funding Agency for Innovation, Finland, Medical Research Center Oulu (MRC Oulu), Oulu, Finland, Orion Research Foundation, Finland, Instrumentarium Science Foundation, Finland, Emil Aaltonen Foundation, Finland, Oulu University Scholarship Foundation, Finland, Finnish Foundation for Cardiovascular Research, Finland, and Finnish Science Foundation for Economics and Technology, Finland.
© 2016, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. Anesthesiology 2017; 126:94-103. Version of Record can be found at https://doi.org/10.1097/ALN.0000000000001385.