Utility of the neurologic intensive care evaluation (NICE) in detecting neurologic deficit after cardiac operations--a pilot study.

Background: Neurocognitive changes are common after cardiac operations. The acute post-operative period is a critical time when significant neurologic changes may be detected and appropriate therapy initiated promptly. Formal neuropsychologic testing in this situation however is impractical so other means of early detection are required.

Anesthesia and temperature effects on somatosensory evoked potentials produced by train stimuli.

Objective: To determine the effect of anesthesia, temperature, and stimulus characteristics on the response of upper extremity somatosensory evoked responses (SSEP) to repetitive stimulation.

Methods: Pairs and trains of electrical stimuli were used to elicit the upper extremity SSEP, and the amplitudes of the N20-P22, N13, and Erb's point potentials produced by each stimulus were measured. The ratio of the amplitude of the response to each stimulus to that produced by the first stimulus in a given train was computed.

Interventions for reversing delayed-onset postoperative paraplegia after thoracic aortic reconstruction.

Background: Delayed postoperative paraplegia is a recognized complication of thoracic (TAA) or thoracoabdominal aortic aneurysm (TAAA) repair. The purpose of this study was to evaluate the effectiveness of interventions to treat delayed-onset paraplegia.

Methods: Between January 1, 2000 and August 31, 2001, 99 patients underwent surgical repair of TAA, Crawford type I, II, or III TAAA.

Effects of acute hypoxemia/ischemia on EEG and evoked responses at normothermia and hypothermia in humans.

Background: Hypothermia is used clinically to prevent neurologic injury but the degree of protection which it affords at various levels of the nervous system in humans is difficult to establish.

Material/methods: The temporal changes in EEG amplitude and somatosensory evoked potential (SEP) amplitudes in a patient experiencing acute normothermic hypoxemia, a patient experiencing acute circulatory arrest at moderate hypothermia and a collection of patients undergoing deep hypothermic circulatory arrest were analyzed to determine the rate at which changes occur during acute lack of oxygen delivery at various temperatures.

Results: In each case, it was found that more rostrally generated potentials disappeared more quickly than more peripheral potentials.