Continuity with caveats in anesthesia: state and response entropy of the EEG

AbstractThe 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 distinctpillarindices  for both SE and RE, i.e., index values with a higher probability of occurrence than others. These pillarindex  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 prominentpillar indices  with a...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research