{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:55:43Z","timestamp":1777938943254,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Helsinki University Hospital Special Funds"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Circulatory arrest carries a high risk of neurological damage, but modern monitoring methods lack reliability, and is susceptible to the generalized effects of both anesthesia and hypothermia. The objective of this prospective, explorative study was to research promising, reliable, and noninvasive methods of neuromonitoring, capable of predicting neurological outcome after hypothermic circulatory arrest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Thirty patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta were recruited in a single center and over the course of 4\u2009years. Neuromonitoring was performed with a four-channel electroencephalogram montage and a near-infrared spectroscopy monitor. All data were tested off-line against primary neurological outcome, which was poor if the patient suffered a significant neurological complication (stroke, operative death).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A poor primary neurological outcome seen in 10 (33%) patients. A majority (63%) of the cases were emergency surgery, and thus, no neurological baseline evaluation was possible. The frontal hemispheric asymmetry of electroencephalogram, as measured by the brain symmetry index, predicted primary neurological outcome with a sensitivity of 79 (interquartile range; 62%\u201388%) and specificity of 71 (interquartile range; 61%\u201384%) during the first 6\u2009h after end of circulatory arrest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The hemispheric asymmetry of frontal electroencephalogram is inherently resistant to generalized dampening effects and is predictive of primary neurological outcome. The brain symmetry index provides an easy-to-use, noninvasive neuromonitoring method for surgery of the thoracic aorta and postoperative intensive care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1457496919863942","type":"journal-article","created":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T00:46:21Z","timestamp":1563410781000},"page":"320-327","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Noninvasive Neuromonitoring of Hypothermic Circulatory Arrest in Aortic Surgery"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1554-3502","authenticated-orcid":false,"given":"J. A.","family":"Stewart","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart and Lung Center, Helsinki University Hospital (HUS) and University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. O. K.","family":"S\u00e4rkel\u00e4","sequence":"additional","affiliation":[{"name":"GE Healthcare Finland Oy, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Salmi","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Wennervirta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. P.","family":"Vakkuri","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. L. S.","family":"Vainikka","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Suojaranta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"M\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Neuropsychology, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V. H.","family":"Ilkka","sequence":"additional","affiliation":[{"name":"University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Vierti\u00f6-Oja","sequence":"additional","affiliation":[{"name":"GE Healthcare Finland Oy, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.-S.","family":"Salminen","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"issue":"3","key":"bibr1-1457496919863942","first-page":"303","volume":"2","author":"Ziganshin BA","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"bibr2-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3282f3f499"},{"key":"bibr3-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2010.03.016"},{"key":"bibr4-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00824-5"},{"key":"bibr5-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep299"},{"key":"bibr6-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1007\/BF03018586"},{"key":"bibr7-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2011.0242"},{"key":"bibr8-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-015-3834-x"},{"issue":"5","key":"bibr9-1457496919863942","first-page":"353","volume":"21","author":"Scheuer M","year":"2004","journal-title":"J Clin Neurophysiol"},{"key":"bibr10-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-003-2046-y"},{"key":"bibr11-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000049"},{"key":"bibr12-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2003.12.002"},{"key":"bibr13-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000144649.49861.1d"},{"key":"bibr14-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2006.08.007"},{"key":"bibr15-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0b013e31816ef725"},{"key":"bibr16-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2007.07.019"},{"issue":"2","key":"bibr17-1457496919863942","first-page":"163","volume":"2","author":"Yan T","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"bibr18-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-014-0159-2"},{"key":"bibr19-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198404000-00004"},{"key":"bibr20-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23944"},{"key":"bibr21-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2004.07.007"},{"key":"bibr22-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/68.3.589"},{"key":"bibr23-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001742"},{"key":"bibr24-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.05.092"},{"key":"bibr25-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000180205.85490.85"},{"key":"bibr26-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2008.00644.x"},{"key":"bibr27-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.630400"},{"key":"bibr28-1457496919863942","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.9.327"}],"container-title":["Scandinavian Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1457496919863942","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1457496919863942","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1457496919863942","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:57:23Z","timestamp":1777697843000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1457496919863942"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,17]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1177\/1457496919863942"],"URL":"https:\/\/doi.org\/10.1177\/1457496919863942","relation":{},"ISSN":["1457-4969","1799-7267"],"issn-type":[{"value":"1457-4969","type":"print"},{"value":"1799-7267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,17]]}}}