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ICU EEG

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https://www.readbyqxmd.com/read/28219810/continuous-electroencephalography-in-a-mixed-non-neurological-intensive-care-population-an-observational-study
#1
Patrick Schramm, Judyta Luczak, Kristin Engelhard, Jasmin El Shazly, Martin Juenemann, Marlene Tschernatsch
PURPOSE: Continuous electroencephalography (cEEG) improves monitoring of the brain in unconscious patients, but implementation at ICU is difficult. The present investigation shows a way to introduce cEEG at an anesthesiological ICU and discusses the first experiences. MATERIALS AND METHODS: The study analyzed the feasibility of cEEG, assessed the interpretable cEEG time, importance of automatic seizure detection, the incidence of seizures, the predominant background EEG activity, incidence of delirium and mortality...
February 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28187794/continuous-eeg-monitoring-in-the-intensive-care-unit
#2
G B Young, J Mantia
The purpose and indications for continuous electroencephalography monitoring (CEEG) in intensive care unit (ICU) patients include seizure detection, monitoring the effects of treatment (including depth of sedation), grading and classification of EEG abnormalities, ischemia detection and prognostication. Practical considerations of ICU CEEG include: choice of montages (patterns of electrode placement and connections), EEG electrodes, recognition of artifacts, and the use of automated or computerized analysis...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28160596/continuous-electroencephalography-ceeg-monitoring-and-outcomes-of-critically-ill-patients
#3
Ayaz M Khawaja, Guoqiao Wang, Gary R Cutter, Jerzy P Szaflarski
BACKGROUND It is not clear whether performing continuous EEG (cEEG) in critically ill patients during intensive care unit (ICU) treatment affects outcomes at discharge. MATERIAL AND METHODS We prospectively matched 234 patients who received cEEG (cases) by admission diagnosis and sex to 234 patients who did not receive cEEG (controls) and followed them until discharge. Patients admitted due to seizures were excluded. The primary measures of outcome were Glasgow Coma Scale at Discharge (GCSD) and disposition at discharge, and the secondary measures of outcome were AED modifications, Glasgow Outcomes Scale, and Modified-Rankin Scale...
February 4, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28151826/continuous-electroencephalographic-monitoring-in-the-icu-an-overview-of-current-strengths-and-future-challenges
#4
Danny M W Hilkman, Walther N K A van Mook, Vivianne H J M van Kranen-Mastenbroek
PURPOSE OF REVIEW: In ICUs, numerous physiological parameters are continuously monitored and displayed. Yet, functional monitoring of the organ of primary concern, the brain, is not routinely performed. Despite the benefits of ICU use of continuous electroencephalographic (EEG)-monitoring (cEEG) is increasingly recognized, several issues nevertheless seem to hamper its widespread clinical implementation. RECENT FINDINGS: Utilization of ICU cEEG has significantly improved detection and characterization of cerebral pathology, prognostication and clinical management in specific patient groups...
February 1, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28110410/neurophysiological-assessment-of-brain-dysfunction-in-critically-ill-patients-an-update
#5
REVIEW
Eric Azabou, Catherine Fischer, Jean Michel Guerit, Djillali Annane, François Mauguiere, Fréderic Lofaso, Tarek Sharshar
The aim of this review was to provide up-to-date information about the usefulness of clinical neurophysiology testing in the management of critically ill patients. Evoked potentials (EPs) and electroencephalogram (EEG) are non-invasive clinical neurophysiology tools that allow an objective assessment of the central nervous system's function at the bedside in intensive care unit (ICU). These tests are quite useful in diagnosing cerebral complications, and establishing the vital and functional prognosis in ICU...
January 21, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28092846/status-epilepticus-in-patients-with-cirrhosis-how-to-avoid-misdiagnosis-in-patients-with-hepatic-encephalopathy
#6
Marika Rudler, Clémence Marois, Nicolas Weiss, Dominique Thabut, Vincent Navarro
PURPOSE: Status epilepticus (SE) in patients with cirrhosis is a rare but serious situation. Diagnosis may be difficult in emergency presentation, especially when patients present with hepatic encephalopathy (HE). Misdiagnosis must be avoided since some anti-epileptic drugs aggravate HE. In this retrospective study, we therefore assessed the frequency of SE in patients with cirrhosis, evaluated the accuracy of diagnosis and determined rates of mortality. METHOD: We reviewed data from all patients hospitalized from 2005 to 2013 in the Hepatology ICU for complications of cirrhosis with an initial diagnosis of SE...
December 27, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#7
REVIEW
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27894023/persistent-generalized-periodic-discharges-a-specific-marker-of-fatal-outcome-in-cerebral-hypoxia
#8
Roland Renzel, Christian R Baumann, Ian Mothersill, Rositsa Poryazova
OBJECTIVES: Electroencephalography (EEG) is one of the methods used in predicting the outcome after cerebral hypoxia. In this study we aim to evaluate the significance of generalized periodic discharges (GPD) as a prognostic marker. METHODS: We retrospectively analyzed the medical histories of patients, who underwent an EEG after cardiac arrest during the time period from 2005 to 2013 at the University Hospital Zurich. All EEGs were re-interpreted using the 2012 American Clinical Neurophysiology Society (ACNS) classification for intensive care unit (ICU) EEGs...
January 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27886628/eeg-utilization-in-canadian-intensive-care-units-a-multicentre-prospective-observational-study
#9
Andrea Park, Martin Chapman, Victoria A McCredie, Derek Debicki, Teneille Gofton, Loretta Norton, J Gordon Boyd
PURPOSE: We have previously shown that electroencephalography (EEG) may be an underutilized monitoring modality in a single general medical-surgical ICU, that does not have a specific neurocritical care consultation service or neurocritical care unit. The present study was designed to describe the pattern of EEG utilization across 3 academic ICUs in Ontario, Canada that use different models of neurocritical care. METHOD: In this prospective multicentre observational study, ICU patients were screened weekly for 6 non-consecutive weeks to determine if they met the ESICM's recommendations or suggestions for EEG monitoring...
December 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27851463/1828-use-of-amplitude-integrated-eeg-for-super-refractory-status-epilepticus-and-effective-icu-management
#10
Michael Miksa, Gracia Mui, Susan Duberstein Coad
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27771198/yield-of-repeated-intermittent-eeg-for-seizure-detection-in-critically-ill-adults
#11
Yannick Fogang, Benjamin Legros, Chantal Depondt, Nicolas Mavroudakis, Nicolas Gaspard
INTRODUCTION: Seizures are common in critically ill patients and prevalence can exceed 30% in the neuro-intensive care unit (ICU). Continuous EEG monitoring (cEEG) is the gold standard for seizure detection in critically ill patients. OBJECTIVES: To determine the yield of intermittent EEG (iEEG) to detect critically ill adult patients with seizures and to identify the factors that affect this yield. METHODS: We retrospectively analyzed cEEG data and medical records from 977 consecutive critically ill patients undergoing cEEG...
October 19, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27749503/aliasing-of-60-hz-artifact-due-to-compressed-timebase
#12
Robert D Bolen, Jonathan J Halford, Jonathan C Edwards
INTRODUCTION: Digital EEG has brought about greater flexibility in data interpretation but has also resulted in new and unique artifacts. As digital EEG has evolved, an increase in ICU monitoring has occurred, bringing more sources of artifact to light. Aliasing due to a combination of compressed timebase and display monitor resolution can result in appearance of spurious waveforms that can potentially skew interpretation. METHODS: A portion of a digital EEG from an ICU patient acquired at a sample rate of 1024 Hz was reviewed at a timebase of 15 mm/sec on a monitor with a resolution of 1920x1080...
October 5, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27749460/utility-of-continuous-eeg-monitoring-in-noncritically-lll-hospitalized-patients
#13
Santoshi Billakota, Saurabh R Sinha
INTRODUCTION: Continuous EEG (cEEG) monitoring is used in the intensive care unit (ICU) setting to detect seizures, especially nonconvulsive seizures and status epilepticus. The utility and impact of such monitoring in non-ICU patients are largely unknown. METHODS: Hospitalized patients who were not in an ICU and underwent cEEG monitoring in the first half of 2011 and 2014 were identified. Reason for admission, admitting service (neurologic and nonneurologic), indication for cEEG, comorbid conditions, duration of recording, EEG findings, whether an event/seizure was recorded, and impact of EEG findings on management were reviewed...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27748723/seizures-and-epileptiform-discharges-in-patients-with-acute-subdural-hematoma
#14
Sebastian Pollandt, Bichun Ouyang, Thomas P Bleck, Katharina M Busl
PURPOSE: Subdural hematomas (SDH) are associated with seizures and epileptiform discharges, but little is known about the prevalence and impact of seizures, status epilepticus (SE), and epileptiform discharges on outcomes in patients with isolated acute SDH (aSDH). METHODS: Continuous EEG reports from 76 adult patients admitted to Rush University Medical Center with aSDH between January 2009 and March 2012 were reviewed. Clinical and radiographic findings, comorbidities, treatment, and outcome parameters, such as mortality, discharge destination, need for tracheostomy/percutaneous endoscopic gastrostomy placement, and length of stay (LOS), were assessed...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27695621/observed-medical-and-surgical-complications-of-prolonged-barbiturate-coma-for-refractory-status-epilepticus
#15
Christopher R Newey, Dolora Wisco, Premkumar Nattanmai, Aarti Sarwal
BACKGROUND: Refractory status epilepticus is often treated with third-line therapy, such as pentobarbital coma. However, its use is limited by side effects. Recognizing and preventing major and minor adverse effects of prolonged pentobarbital coma may increase good outcomes. This study retrospectively reviewed direct and indirect medical and surgical pentobarbital coma. METHODS: Retrospective chart review of all patients with refractory status epilepticus treated with pentobarbital over a 1 year period at a large tertiary care center...
October 2016: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/27651213/stimulus-induced-bursts-in-severe-postanoxic-encephalopathy
#16
Marleen C Tjepkema-Cloostermans, Elisabeth T Wijers, Michel J A M van Putten
OBJECTIVE: To report on a distinct effect of auditory and sensory stimuli on the EEG in comatose patients with severe postanoxic encephalopathy. METHODS: In two comatose patients admitted to the Intensive Care Unit (ICU) with severe postanoxic encephalopathy and burst-suppression EEG, we studied the effect of external stimuli (sound and touch) on the occurrence of bursts. RESULTS: In patient A bursts could be induced by either auditory or sensory stimuli...
August 26, 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27611442/utility-of-electroencephalography-experience-from-a-u-s-tertiary-care-medical-center
#17
Kapil Gururangan, Babak Razavi, Josef Parvizi
OBJECTIVE: To investigate the utility of electroencephalography (EEG) for evaluation of patients with altered mental status (AMS). METHODS: We retrospectively reviewed 200 continuous EEGs (cEEGs) obtained in ICU and non-ICU wards and 100 spot EEGs (sEEGs) obtained from the emergency department (ED) of a large tertiary medical center. Main outcomes were access time (from study request to hookup), and diagnostic yield (percentage of studies revealing significant abnormality)...
October 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27571047/the-utility-of-clinical-features-for-the-diagnosis-of-seizures-in-the-intensive-care-unit
#18
Sarah E Schmitt
INTRODUCTION: Seizures in the intensive care unit (ICU) are often subtle, and may have little or no clinical correlate. This study attempts to determine what clinical features are most strongly associated with the presence of electrographic seizures on continuous EEG (cEEG) monitoring. METHODS: A retrospective review for all patients who underwent cEEG monitoring between Jan. 2003 and Mar. 2009 for either characterization of clinical events or altered mental status was performed...
August 26, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27475280/ketogenic-diet-treatment-for-pediatric-super-refractory-status-epilepticus
#19
Brian Appavu, Lisa Vanatta, John Condie, John F Kerrigan, Randa Jarrar
PURPOSE: We aimed to study whether ketogenic diet (KD) therapy leads to resolution of super-refractory status epilepticus in pediatric patients without significant harm. METHOD: A retrospective review was performed at Phoenix Children's Hospital on patients with super-refractory status epilepticus undergoing ketogenic diet therapy from 2011 to 2015. RESULTS: Ten children with super-refractory status epilepticus, ages 2-16 years, were identified...
October 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27466474/sensitivity-of-quantitative-eeg-for-seizure-identification-in-the-intensive-care-unit
#20
Hiba A Haider, Rosana Esteller, Cecil D Hahn, M Brandon Westover, Jonathan J Halford, Jong W Lee, Mouhsin M Shafi, Nicolas Gaspard, Susan T Herman, Elizabeth E Gerard, Lawrence J Hirsch, Joshua A Ehrenberg, Suzette M LaRoche
OBJECTIVE: To evaluate the sensitivity of quantitative EEG (QEEG) for electrographic seizure identification in the intensive care unit (ICU). METHODS: Six-hour EEG epochs chosen from 15 patients underwent transformation into QEEG displays. Each epoch was reviewed in 3 formats: raw EEG, QEEG + raw, and QEEG-only. Epochs were also analyzed by a proprietary seizure detection algorithm. Nine neurophysiologists reviewed raw EEGs to identify seizures to serve as the gold standard...
August 30, 2016: Neurology
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