Off pump BD Glenn: BIS correlation

Background Bidirectional Glenn procedure can be performed without cardiopulmonary bypass (CPB) with some advantages. But the effect of high central venous pressure can be detrimental on the brain. This short study was undertaken to see the effect of off pump Glenn on Bispectral index (BIS), a sensitive neuro monitor. Method The mean increase in superior vena cava (SVC) pressure, fall in BIS values and postoperative neurological outcomes were observed in five children operated for this procedure. Result The mean age of the patients was 3.09±1.4 years and the mean weight was 10.9±4.6Kg. The mean pre procedure SVC pressure was 5±3 mmHg. The maximum increase in SVC pressure was 38 ± 8.2mmHg from baseline. The mean SVC clamptime was 6.8±2.4 min and the fall in BIS from baseline was 20± 10.2. The lowest BIS recorded was 18. There were no neurological problems. Conclusion In conclusion, BIS is an important adjunct to neuromonitoring in off pump Glenn and should be maintained as near to the normal anaesthetic values of 40–60 as possible by various neuroprotective strategies like maintaining a transcranial gradient, hypothermia and neuroprotective drugs.