TY - JOUR
T1 - Continuity with caveats in anesthesia
T2 - state and response entropy of the EEG
AU - Ebensperger, Max
AU - Kreuzer, Matthias
AU - Kratzer, Stephan
AU - Schneider, Gerhard
AU - Schwerin, Stefan
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - The growing use of neuromonitoring in general anesthesia provides detailed insights into the effects of anesthetics on the brain. Our study focuses on the processed EEG indices State Entropy (SE), Response Entropy (RE), and Burst Suppression Ratio (BSR) of the GE EntropyTM Module, which serve as surrogate measures for estimating the level of anesthesia. While retrospectively analyzing SE and RE index values from patient records, we encountered a technical anomaly with a conspicuous distribution of index values. In this single-center, retrospective study, we analyzed processed intraoperative electroencephalographic (EEG) data from 15,608 patients who underwent general anesthesia. We employed various data visualization techniques, including histograms and heat maps, and fitted custom non-Gaussian curves. Individual patients’ anesthetic periods were evaluated in detail. To compare distributions, we utilized the Kolmogorov–Smirnov test and Kullback–Leibler divergence. The analysis also included the influence of the BSR on the distribution of SE and RE values. We identified distinct pillar indices for both SE and RE, i.e., index values with a higher probability of occurrence than others. These pillar index values were not age-dependent and followed a non-equidistant distribution pattern. This phenomenon occurs independently of the BSR distribution. SE and RE index values do not adhere to a continuous distribution, instead displaying prominent pillar indices with a consistent pattern of occurrence across all age groups. The specific features of the underlying algorithm responsible for this pattern remain elusive.
AB - The growing use of neuromonitoring in general anesthesia provides detailed insights into the effects of anesthetics on the brain. Our study focuses on the processed EEG indices State Entropy (SE), Response Entropy (RE), and Burst Suppression Ratio (BSR) of the GE EntropyTM Module, which serve as surrogate measures for estimating the level of anesthesia. While retrospectively analyzing SE and RE index values from patient records, we encountered a technical anomaly with a conspicuous distribution of index values. In this single-center, retrospective study, we analyzed processed intraoperative electroencephalographic (EEG) data from 15,608 patients who underwent general anesthesia. We employed various data visualization techniques, including histograms and heat maps, and fitted custom non-Gaussian curves. Individual patients’ anesthetic periods were evaluated in detail. To compare distributions, we utilized the Kolmogorov–Smirnov test and Kullback–Leibler divergence. The analysis also included the influence of the BSR on the distribution of SE and RE values. We identified distinct pillar indices for both SE and RE, i.e., index values with a higher probability of occurrence than others. These pillar index values were not age-dependent and followed a non-equidistant distribution pattern. This phenomenon occurs independently of the BSR distribution. SE and RE index values do not adhere to a continuous distribution, instead displaying prominent pillar indices with a consistent pattern of occurrence across all age groups. The specific features of the underlying algorithm responsible for this pattern remain elusive.
KW - Anesthesia
KW - Burst suppression
KW - Electroencephalogram
KW - Response entropy
KW - State entropy
UR - http://www.scopus.com/inward/record.url?scp=85189334087&partnerID=8YFLogxK
U2 - 10.1007/s10877-024-01130-9
DO - 10.1007/s10877-024-01130-9
M3 - Article
AN - SCOPUS:85189334087
SN - 1387-1307
JO - Journal of Clinical Monitoring and Computing
JF - Journal of Clinical Monitoring and Computing
ER -