{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:17:14Z","timestamp":1783343834036,"version":"3.54.6"},"reference-count":33,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Maintaining optimal anesthetic depth during cardiopulmonary bypass (CPB) in pediatric patients is challenging due to altered physiology and unreliable conventional monitoring. Entropy, a processed electroencephalogram metric, offers a potential solution. This study aimed to evaluate the relationship between end oxygenator sevoflurane concentration and entropy values during pediatric CPB using fixed-dose versus entropy-guided sevoflurane administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>A prospective, randomized study was conducted on 62 pediatric patients undergoing congenital heart surgery with CPB. Patients were allocated into two groups: Group A received fixed-dose sevoflurane (1% v\/v), and Group B received sevoflurane titrated to maintain entropy values between 40 and 60. Parameters such as end oxygenator sevoflurane concentration, entropy (Response and State entropy, RE and SE), and sevoflurane consumption were recorded intraoperatively. Postoperative hemodynamic data, length of stay, and complication rates were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Entropy-guided patients showed significantly higher end oxygenator sevoflurane concentrations [1.64 (1.51\u20131.85)% versus 1.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .001] and sevoflurane consumption (1.26 \u00b1 0.12 vs 0.645 \u00b1 0.03\u00a0mL\/min,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .001). RE and SE values were significantly lower in the entropy group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .001), indicating better anesthetic depth control. A negative correlation was found between entropy and sevoflurane concentration (r = \u22120.6987,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .02). Despite higher postoperative inotropic scores in the entropy group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .001), no significant differences were found in length of stay, mechanical ventilation duration, or morbidity and mortality rates between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Entropy-guided sevoflurane administration during pediatric CPB provides improved anesthetic depth control at the cost of higher anesthetic and inotropic requirements. However, it does not adversely affect clinical outcomes, supporting its safety and potential utility in refining pediatric anesthesia practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591251386601","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T23:40:03Z","timestamp":1759534803000},"page":"731-739","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Entropy-guided sevoflurane administration during cardiopulmonary bypass surgery in the paediatric population"],"prefix":"10.1177","volume":"41","author":[{"given":"Abhinay","family":"Ankur","sequence":"first","affiliation":[{"name":"Armed Forces Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2037-2173","authenticated-orcid":false,"given":"Alok","family":"Kumar","sequence":"additional","affiliation":[{"name":"Armed Forces Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markose L.","family":"Paret","sequence":"additional","affiliation":[{"name":"INHS Asvini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saajan","family":"Joshi","sequence":"additional","affiliation":[{"name":"Armed Forces Medical College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Badal","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia & Critical Care, Command Hospital (CC)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000612"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2013.05.030"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659114531314"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael050"},{"key":"e_1_3_3_6_2","first-page":"324","article-title":"Monitoring techniques; neuromuscular blockade and depth of anaesthesia","volume":"18","author":"Wycherley AS","year":"2017","unstructured":"Wycherley AS, Bembridge JL. Monitoring techniques; neuromuscular blockade and depth of anaesthesia. Intensive Care Med 2017; 18: 324\u2013327.","journal-title":"Intensive Care Med"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1515\/jim-2017-0027"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.35995\/ceacr1010001"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0102900516"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12055-022-01373-8"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000285"},{"issue":"2","key":"e_1_3_3_12_2","first-page":"140","article-title":"Optimising sevoflurane administration during paediatric cardiopulmonary bypass","volume":"5","author":"Kumar A","year":"2023","unstructured":"Kumar A, Ghotra GS, Shukla R, et al. Optimising sevoflurane administration during paediatric cardiopulmonary bypass. J Anesthetic Anesthesiol 2023; 5(2): 140\u2013148.","journal-title":"J Anesthetic Anesthesiol"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0001-5172.2004.00322.x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200604000-00015"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200508000-00010"},{"issue":"2","key":"e_1_3_3_16_2","first-page":"288","article-title":"Closed-loop co-administration of propofol and remifentanil guided by the bispectral index: a randomized multicenter study","volume":"122","author":"Liu N","year":"2016","unstructured":"Liu N, Chazot T, Hamada S, et al. Closed-loop co-administration of propofol and remifentanil guided by the bispectral index: a randomized multicenter study. Anesth Analg 2016; 122(2): 288\u2013295.","journal-title":"Anesth Analg"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/s101210896"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000246838.93153.23"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-9784.124115"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-48110-6.00003-X"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet018"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000612"},{"issue":"3","key":"e_1_3_3_23_2","first-page":"348","article-title":"Estimation of volatile anesthetic concentrations during CPB: comparison between oxygenator outflow and end-tidal concentrations","volume":"23","author":"Wakasugi M","year":"2009","unstructured":"Wakasugi M, Hirota K, Doi M, et al. Estimation of volatile anesthetic concentrations during CPB: comparison between oxygenator outflow and end-tidal concentrations. J Cardiothorac Vasc Anesth 2009; 23(3): 348\u2013353.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"3","key":"e_1_3_3_24_2","first-page":"777","article-title":"Monitoring volatile anesthetic concentrations during CPB","volume":"96","author":"Wollman SB","year":"2003","unstructured":"Wollman SB, Scher CS. Monitoring volatile anesthetic concentrations during CPB. Anesth Analg 2003; 96(3): 777\u2013783.","journal-title":"Anesth Analg"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000130261.90896.6C"},{"issue":"6","key":"e_1_3_3_26_2","first-page":"725","article-title":"Depth of sedation in children undergoing CT scan: validity and reliability of the university of Michigan Sedation Scale (UMSS)","volume":"96","author":"Malviya S","year":"2006","unstructured":"Malviya S, Voepel-Lewis T, Tait AR, et al. Depth of sedation in children undergoing CT scan: validity and reliability of the university of Michigan Sedation Scale (UMSS). Br J Anaesth 2006; 96(6): 725\u2013730.","journal-title":"Br J Anaesth"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2010.02212.x"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei247"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2004.03.004"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181b806fc"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16300-9"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1100403"},{"issue":"2","key":"e_1_3_3_33_2","first-page":"ii9","article-title":"Clinical evidence for the neurotoxicity of anaesthesia in children","volume":"113","author":"Davidson AJ","year":"2004","unstructured":"Davidson AJ, Sun LS. Clinical evidence for the neurotoxicity of anaesthesia in children. Br J Anaesth 2004; 113(Suppl 2): ii9\u2013ii13.","journal-title":"Br J Anaesth"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei047"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251386601","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591251386601","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591251386601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T12:29:48Z","timestamp":1783340988000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591251386601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":33,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/02676591251386601"],"URL":"https:\/\/doi.org\/10.1177\/02676591251386601","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]}}}