Recent applications of quantitative electroencephalography in adult intensive care units: a comprehensive review

Cho, Sung Min; Ritzl, Eva K.

doi:10.1007/s00415-022-11337-y

Cited by 9 publications

(18 citation statements)

References 94 publications

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“…Different qEEG monitors are available and able to generate several graphs/trends, allowing ICU physicians to rapidly screen long periods of EEG to detect changes over time [19]. Commonly used trends include [19][20][21]:…”

Section: Burst Suppressionmentioning

confidence: 99%

“…Colors may vary according to the manufacturer [19,20]. CDSA is generally utilized for seizure detection [21][22][23][24] (Fig. 7).…”

Section: Color Density Spectral Arraymentioning

confidence: 99%

“…Seizures are associated with an increase in frequency and amplitude of the EEG. This manifests on the CDSA trend as a paroxysmal event with increased power (i.e., a "solid flame" pattern presenting as an abrupt onset of higher EEG power with a smooth edge similar to candlelight) [19][20][21].…”

Section: Color Density Spectral Arraymentioning

confidence: 99%

“…Definition This method compares the power of a frequency band between hemispheres [20,21]. The provided index may be expressed as an absolute number (i.e., the higher the number, the greater the asymmetry) or as a relative value (i.e., a positive or negative value differentiates between higher power on one side as compared to the other) [21]. In a spectrogram (frequency range displayed on the y-axis), the utilized color may indicate the side with more power…”

Section: Asymmetry Indexmentioning

confidence: 99%

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Non-invasive technology for brain monitoring: definition and meaning of the principal parameters for the International PRactice On TEChnology neuro-moniToring group (I-PROTECT)

Romagnoli,

Lobo,

Picetti

et al. 2024

J Clin Monit Comput

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Technologies for monitoring organ function are rapidly advancing, aiding physicians in the care of patients in both operating rooms (ORs) and intensive care units (ICUs). Some of these emerging, minimally or non-invasive technologies focus on monitoring brain function and ensuring the integrity of its physiology. Generally, the central nervous system is the least monitored system compared to others, such as the respiratory, cardiovascular, and renal systems, even though it is a primary target in most therapeutic strategies. Frequently, the effects of sedatives, hypnotics, and analgesics are entirely unpredictable, especially in critically ill patients with multiple organ failure. This unpredictability exposes them to the risks of inadequate or excessive sedation/hypnosis, potentially leading to complications and long-term negative outcomes. The International PRactice On TEChnology neuro-moniToring group (I-PROTECT), comprised of experts from various fields of clinical neuromonitoring, presents this document with the aim of reviewing and standardizing the primary non-invasive tools for brain monitoring in anesthesia and intensive care practices. The focus is particularly on standardizing the nomenclature of different parameters generated by these tools. The document addresses processed electroencephalography, continuous/quantitative electroencephalography, brain oxygenation through near-infrared spectroscopy, transcranial Doppler, and automated pupillometry. The clinical utility of the key parameters available in each of these tools is summarized and explained. This comprehensive review was conducted by a panel of experts who deliberated on the included topics until a consensus was reached. Images and tables are utilized to clarify and enhance the understanding of the clinical significance of non-invasive neuromonitoring devices within these medical settings.

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Section: Burst Suppressionmentioning

confidence: 99%

“…Colors may vary according to the manufacturer [19,20]. CDSA is generally utilized for seizure detection [21][22][23][24] (Fig. 7).…”

Section: Color Density Spectral Arraymentioning

confidence: 99%

Section: Color Density Spectral Arraymentioning

confidence: 99%

Section: Asymmetry Indexmentioning

confidence: 99%

See 2 more Smart Citations

Non-invasive technology for brain monitoring: definition and meaning of the principal parameters for the International PRactice On TEChnology neuro-moniToring group (I-PROTECT)

Romagnoli,

Lobo,

Picetti

et al. 2024

J Clin Monit Comput

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“…The gold standard to assess electrocortical activity is continuous full-channel EEG but suffers from high barriers to implementation even in high-resource settings [4]. To facilitate the detection of changes of EEG activity despite the absence of EEG-trained personnel, mathematical transformations of raw EEG curves are increasingly applied in intensive care settings [5][6][7]. These transformations provide time-compressed quantitative trend information on specific features, such as amplitude, frequency, symmetry or burst rate and are summarized with the term quantitative EEG (qEEG).…”

Section: Introductionmentioning

confidence: 99%

Bilaterally suppressed EEG amplitudes predict death and poor functional outcomes in critically ill children

Paul,

Greve,

Hegemann

et al. 2023

Preprint

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Background and objectivesContinuous full-channel EEG is the gold standard for electrocortical activity assessment in critically ill children, but its implementation faces challenges, leading to a growing use of amplitude-integrated EEG (aEEG). While suppressed aEEG amplitudes have been linked to adverse outcomes in preterm infants and adults after cardiac arrest, evidence for critically ill children remains limited. This retrospective study aimed to evaluate the association between suppressed aEEG amplitudes in critically ill children and death or poor functional neurological outcomes.Methods235 EEGs derived from individual patients < 18 years in the pediatric intensive care unit (PICU) at the University Hospital Essen (Germany) between 04/2014 and 07/2021 were retrospectively converted into aEEGs and amplitudes analyzed with respect to previously defined age-specific percentiles. Adjusted odds ratios for death and poor functional outcome at hospital discharge in patients with bilateral upper or lower amplitude suppression below the 10thpercentile were calculated accounting for neurological injuries, acute disease severity, sedation levels, and functional neurological status before acute critical illness.ResultsThe median time from neurological insult to EEG recording was 2 days. PICU admission occurred due to neurological reasons in 43 % and patients had high overall disease severity. Thirty-three (14 %) patients died and 68 (29 %) had poor outcomes. Amplitude depression below the 10thpercentile was frequent (upper amplitude: 27 %, lower amplitude: 34 %) with suppression of only one amplitude less frequent than bilateral suppression. Multivariable regression analyses yielded odds between 6.63 and 15.22 for death, neurological death, and poor neurological outcomes if both upper or both lower amplitudes were suppressed. Model discrimination was excellent with areas under the curve above 0.92 for all models.DiscussionThis study found a high prevalence of suppressed aEEG amplitudes in critically ill children early after PICU admission, with suppression being highly associated with death and poor functional outcomes at hospital discharge. These findings emphasize the potential of early identification of high-risk PICU patients through aEEG monitoring if conventional EEG is unavailable, potentially guiding neuroprotective therapies and early neurorehabilitation.

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A nomogram based on quantitative EEG to predict the prognosis of nontraumatic coma patients in the neuro-intensive care unit

Qin,

Cao,

et al. 2024

Intensive and Critical Care Nursing

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Recent applications of quantitative electroencephalography in adult intensive care units: a comprehensive review

Cited by 9 publications

References 94 publications

Non-invasive technology for brain monitoring: definition and meaning of the principal parameters for the International PRactice On TEChnology neuro-moniToring group (I-PROTECT)

Non-invasive technology for brain monitoring: definition and meaning of the principal parameters for the International PRactice On TEChnology neuro-moniToring group (I-PROTECT)

Bilaterally suppressed EEG amplitudes predict death and poor functional outcomes in critically ill children

A nomogram based on quantitative EEG to predict the prognosis of nontraumatic coma patients in the neuro-intensive care unit

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