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Module 5B: Proprietary Devices (ICETAP)

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on 11 January 2015

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Transcript of Module 5B: Proprietary Devices (ICETAP)

Module 5B
Quantitative EEG- Proprietary Devices

Content and Prezi by: Andrew Park
Bispectral Index
Cerebral State Monitor

Proprietary Devices
Bispectral Index (BIS)
Developed by Aspect Medical Systems (now acquired by Covidien)
Processes raw EEG data acquired through sensor placed on patient’s forehead

Sample BIS waveform with different sweep speeds and its index
Proprietary algorithm gives a numerical value between 0 to 100 where 0 represents isoelectricity to 100 representing a fully awake state

Proprietary algorithm is known to incorporate bispectral analysis, power spectral analysis, and time domain analysis

A target value between 40-60 is recommended during maintenance period of anesthesia
Developed by MonitorTechnik (Germany)
Processes raw EEG data acquired through three electrodes attached to patient’s forehead

Most recent Narcotrend software gives two outputs after processing: EEG stage and Index
Stage is given by alphabets A through F where A representing awake state to F being deeply anesthetized
The stage is further categorized into 14 different substages (A, B0-2 , C0-2 , D0-2 , E0,1 , F0,1 )


Index is given as a numerical value from 0 to 100 where 0 represents deep anesthesia to 100 representing awake state

Stages D and E are recommended levels of maintenance anesthesia



Developed by Datex-Ohmeda (GE Healthcare)
Processes raw EEG and FEMG (fast frontalis EMG) signals acquired through sensor attached on forehead

Two parameters are produced after processing the signals: Response Entropy and State Entropy
Response Entropy: Measures frequency range from 0-47 Hz. This value incorporates signal from EEG and FEMG. Output value is 0-100, where 0 is isoelectricity to 100 is awake state. Response time is fast, less than two seconds

State Entropy: Measures frequency range from 0-32 Hz. This value incorporates signal from only EEG. Output value is 0-91, where the scale is same as the response entropy
State Entropy value between 40-60 is considered to adequate level of anesthesia




Response Entropy
State Entropy
Cerebral State Monitor
Developed by Danmeter (Denmark)
Processes raw EEG data acquired through a sensor attached on forehead

Cerebral State Monitor (CSM) uses an algorithm based on fuzzy logic
Four input parameters used to classify Cerebral State Index (CSI): αalpha ratio ,β beta ratio , (beta βratio – alpha αratio ), burst suppression %
CSI is a numerical value between 0-100, where 0 is isoelectricity and 100 is fully awake state
Range of 40-60 is considered adequate for surgical anesthesia



Developed by Hospira (now acquired by Masimo)
Processes raw EEG data acquired through a bilateral 4 channel sensor attached on forehead

EEG data is processed through a proprietary algorithm and gives a value named Patient State Index (PSI)
PSI is a numerical value between 0-100 where 0 represents deep anesthesia to 100 representing awake state
PSI value between 25-50 is recommended for appropriate level of anesthesia for surgery

4 Channel EEG
PSI Trend


Developed by Neurowave
Processes raw EEG data acquired through a bilateral 2-channel sensor attached on forehead

Raw EEG data goes through an open source algorithm processor and gives a value named Wavelet-based Anesthetic Value for Central Nervous System (WAVCNS )
Gamma wave epoch of 1 second is compared to a probability density function of awake and isoelectric state and is assigned a WAVCNS value from 0 – 100
0 denotes isoelectricity where 100 represents awake state
Optimal range of anesthesia is between 40-60



Each Narcotrend stage with corresponding representative EEG
Full transcript