{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:23:32Z","timestamp":1775010212988,"version":"3.50.1"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Anesthesiologists monitor electroencephalography (EEG) intraoperatively to maintain adequate depth of anesthesia. However, the EEG signal is affected by noise and interference. The SedLine\u00ae is a brain function monitor with which the Patient State Index (PSI) is calculated. In this study, we report abnormally high PSI values associated with epicardial pacing during open heart surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 50-year-old man was scheduled for total arch replacement. Atrial demand pacing was started before weaning from cardiopulmonary bypass. The PSI increased from 30 to 80 soon after the start of pacing, and the EEG waveform showed spikes synchronized with the pacing. As the pacing output was lowered, the spikes on the EEG attenuated and disappeared, and the PSI decreased to &lt; 40. When the pacing output was increased again, the spikes recurred, and the PSI increased again.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Pacemaker spikes may cause contamination of the EEG, resulting in abnormally high PSI values.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40981-022-00521-8","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T16:03:27Z","timestamp":1653062607000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Abnormally high Patient State Index associated with epicardial pacing: a case report"],"prefix":"10.1186","volume":"8","author":[{"given":"Hiroki","family":"Yonezawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuma","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiaki","family":"Takise","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Morinaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Ohnishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"issue":"1","key":"521_CR1","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1213\/ANE.0000000000002331","volume":"126","author":"BG Fahy","year":"2018","unstructured":"Fahy BG, Chau DF. The technology of processed electroencephalogram monitoring devices for assessment of depth of anesthesia. Anesth Analg. 2018;126(1):111\u20137.","journal-title":"Anesth Analg"},{"issue":"5","key":"521_CR2","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1007\/s10877-020-00578-9","volume":"35","author":"F von Dincklage","year":"2021","unstructured":"von Dincklage F, Jurth C, Schneider G, P SG, Kreuzer M. Technical considerations when using the EEG export of the SEDLine Root device. J Clin Monit Comput. 2021;35(5):1047\u201354.","journal-title":"J Clin Monit Comput"},{"issue":"6","key":"521_CR3","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1097\/00000539-200212000-00036","volume":"95","author":"X Chen","year":"2002","unstructured":"Chen X, Tang J, White PF, Wender RH, Ma H, Sloninsky A, et al. A comparison of patient state index and bispectral index values during the perioperative period. Anesth Analg. 2002;95(6):1669\u201374 table of contents.","journal-title":"Anesth Analg"},{"issue":"1","key":"521_CR4","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/00003643-200501000-00016","volume":"22","author":"G Vretzakis","year":"2005","unstructured":"Vretzakis G, Dragoumanis C, Ferdi H, Papagiannopoulou P. Influence of an external pacemaker on bispectral index. Eur J Anaesthesiol. 2005;22(1):70\u20132.","journal-title":"Eur J Anaesthesiol"},{"issue":"1","key":"521_CR5","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1186\/s40981-019-0299-x","volume":"5","author":"S Iwata","year":"2019","unstructured":"Iwata S, Sanuki M, Ozaki M. Falsely high patient state index during cardiopulmonary bypass with intra-aortic balloon pumping: a case report. JA Clin Rep. 2019;5(1):80.","journal-title":"JA Clin Rep"},{"issue":"1","key":"521_CR6","first-page":"35","volume":"7","author":"K Kamata","year":"2021","unstructured":"Kamata K, Lipping T, Yli-Hankala A, Jantti V, Yamauchi M. Spurious electroencephalographic activity due to pulsation artifact in the depth of anesthesia monitor. JAClin Rep. 2021;7(1):35.","journal-title":"JAClin Rep"},{"issue":"7","key":"521_CR7","first-page":"774","volume":"87","author":"S Obara","year":"2021","unstructured":"Obara S, Oishi R, Nakano Y, Noji Y, Ebana H, Isosu T, et al. Update on the SedLine\u00ae algorithm for calculating the Patient State Index of older individuals during general anesthesia: a randomized controlled trial. Minerva Anestesiol. 2021;87(7):774\u201385.","journal-title":"Minerva Anestesiol"}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-022-00521-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-022-00521-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-022-00521-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T16:05:05Z","timestamp":1653062705000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-022-00521-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,20]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["521"],"URL":"https:\/\/doi.org\/10.1186\/s40981-022-00521-8","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,20]]},"assertion":[{"value":"23 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 April 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 April 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35"}}