Overview

The parameters for monitoring patient neurological function consist of solutions for measuring neuromuscular transmission (NMT), raw EEG and processed EEG indices, such as Entropy* or BIS**.    

The monitoring of the Central Nervous System is essential to detect sudden and gradual changes in the patients’ brain function and also to observe their individual reactions to various medications. Sedative drugs have their direct effect on the brain, whereas neuromuscular blocking agents take effect at the neuromuscular junction. Monitoring neurological function may help the clinician optimize the treatment of each individual patient. Regardless of the application, all these parameters are developed to serve your everyday monitoring routine: clinical meaningfulness and ease of use of the solutions are the guiding principles in GE Healthcare’s parameter development.

Monitoring neurological function may help the clinician optimize the treatment of each individual patient.

Benefits and Technology

BENEFITS 

Continuous EEG measurement allows you to detect impeding neurological crisis like seizures, hypoxia, and ischemia at a reversible stage.   

With auditory evoked potentials (AEP) our EEG measurement guides timely and physiologically sound interventions to preserve cerebral integrity that may help reverse the neurological complications and further development of neurological injuries.   

Entropy measurement may be used as an aid in monitoring the effects of certain anesthetic agents in adults and may help the user titrate anesthetic drugs according to the individual needs in adults. GE entropy parameters may also be associated with a reduction of anesthetic use and faster emergence from anesthesia with adult patients.   

NMT aids in obtaining optimal conditions for surgery - timing and dosing of NMBAs for safe extubation and for safer recovery from neuromuscular blockage.   

BIS may be used as an aid in monitoring the effects of certain anesthetic agents.

TECHNOLOGY

BIS may be used as an aid in monitoring the effects of certain anesthetic agents.


EEG Monitoring

The Electroencephalography (EEG) is a direct and continuous measure of the cerebral electrical activity and status of the brain. It provides valuable information how the patient is responding to treatment and medication. EEG offers up-to 4 bipolar or referential channels in pre-configured and automatically detected lead sets.   

With the use of EEG and Auditory Evoked Potential (AEP) monitoring the clinicians can detect prevalent brain abnormal condition states and damaging development. EEG being linked to cerebral metabolism, it is sensitive to ischemia and hypoxemia, correlates with cerebral topography, detects neuronal dysfunction at a reversible stage. Clinicians can detect seizure activity and monitor the effect of the seizure treatment and medication. Without EEG monitoring, these brain conditions are in risk of not being detected. Not detected and not treated cerebral brain disorders may result in significant patient safety risk. EEG monitoring is available for CARESCAPE* Modular Monitors as a module.

Entropy Monitoring

Entropy* is an innovative clinical measurement designed to provide information on the state of the brain on hospital patients older than 2 years. Entropy monitoring is based on acquisition and processing of raw EEG and Frontal Electromyograph (FEMG) signals by using the Entropy algorithm, GE Healthcare’s application of spectral entropy easurement. Entropy is available as a module with CARESCAPE Modular Monitors with OR and PACU softwares.   

See the algorithm publication at: Description of the Entropy* algortihm as applied in the Datex-Ohmeda S/5TM Entropy Module, Acta Anresthesiologica Scandinavica 2004; 48: 154-161, H. Viertio-Oja, V. Maja, M. Särkelä, P. Talja, N. Tenkanen, H. Tolvanen-Laakso, M. Paloheimo, A. Vakkuri, A. Yli-Hankala, P. Merilainen.

NMT Monitoring

Neuromuscular Transmission (NMT) is the transfer of an impulse between a nerve and a muscle in the neuromuscular junction. NMT can be blocked by neuromuscular blocking agents – drugs which cause transient muscle paralysis and prevent the patient from moving and breathing spontaneously. Muscle relaxation is used during general anesthesia to enable endotracheal intubation and to provide the surgeon with optimal working conditions. In critical care, muscle relaxation is used during mechanical ventilation to minimize the patient’s work of breathing and to improve oxygenation. 

Neuromuscular transmission monitoring in GE’s products provides integrated measurement of the level of neuromuscular block. It also offers plexus stimulation for Regional Block. The stimulation modes are train of four (TOF), single twitch (ST), double burst stimulation (DBS) and post tetanic count (PTC). NMT monitoring is available for CARESCAPE* Modular Monitors as a module.

BIS Monitoring

The E-BIS module is indicated for monitoring the state of the brain by data acquisition of electroencephalograph (EEG) signals of all hospitalized patients. The Bispectral Index** (BIS**), a processed EEG variable, may be used as an aid in monitoring the effects of certain anesthetic agents. BIS is Aspect Medical Systems technology. Using a sensor placed on the patient’s forehead, BIS monitoring translates information from the electroencephalogram (EEG) into a single number that represents each patient’s level of consciousness. This number – the BIS value – ranges from 100 (indicating an awake patient) to zero (indicating the absence of brain activity). Using the BIS value to guide administration of anesthetic medication, clinicians can make informed decisions for optimal anesthesia.   

BIS monitoring is available for CARESCAPE* Modular Monitors as a module, with Dash monitors it is available as a built-in option.