Value of EEG in outcome prediction of hypoxic-ischemic brain injury in the ICU: A narrative review

Hoedemaekers, Cornelia; Hofmeijer, Jeannette; Horn, Janneke

doi:10.1016/j.resuscitation.2023.109900

Cited by 6 publications

(5 citation statements)

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“…The integration of neurointensive care techniques can enable monitoring of cerebral blood flow and electroencephalography (EEG) signals. The latter is extremely sensitive to ischemia and hypoxia, can reflect rSO 2 to a certain extent by recording changes in brain electrical activity, and can be used to evaluate the metabolic state of brain tissue oxygen demand and oxygen consumption; moreover, the latter has been proven to have excellent ability to predict ischemia in the ICU environment [ 57 ]. Sedative drugs are often used to maintain sedation during neurological intensive care.…”

Section: Discussionmentioning

confidence: 99%

Monitoring of Perioperative Microcirculation Dysfunction by Near-Infrared Spectroscopy for Neurological Deterioration and Prognosis of Aneurysmal Subarachnoid Hemorrhage: An Observational, Longitudinal Cohort Study

Yang,

Tan,

Lin

et al. 2024

Neurol Ther

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Introduction No evidence has established a direct causal relationship between early microcirculation disturbance after aneurysmal subarachnoid hemorrhage (aSAH) and neurological function prognosis, which is the key pathophysiological mechanism of early brain injury (EBI) in patients with aSAH. Methods A total of 252 patients with aSAH were enrolled in the Neurosurgical Intensive Care Unit of Southwest Hospital between January 2020 and December 2022 and divided into the no neurological deterioration, early neurological deterioration, and delayed neurological deterioration groups. Indicators of microcirculation disorders in EBI included regional cerebral oxygen saturation (rSO 2 ) measured by near-infrared spectroscopy (NIRS), brain oxygen monitoring, and other clinical parameters for evaluating neurological function and determining the prognosis of patients with aSAH. Results Our data suggest that the rSO 2 is generally lower in patients who develop neurological deterioration than in those who do not and that there is at least one time point in the population of patients who develop neurological deterioration where left and right cerebral hemisphere differences can be significantly monitored by NIRS. An unordered multiple-classification logistic regression model was constructed, and the results revealed that multiple factors were effective predictors of early neurological deterioration: reoperation, history of brain surgery, World Federation of Neurosurgical Societies (WFNS) grade 4–5, Fisher grade 3–4, SAFIRE grade 3–5, abnormal serum sodium and potassium levels, and reduced rSO 2 during the perioperative period. However, for delayed neurological deterioration in patients with aSAH, only a history of brain surgery and perioperative RBC count were predictive indicators. Conclusions The rSO 2 concentration in patients with neurological deterioration is generally lower than that in patients without neurological deterioration, and at least one time point in the population with neurological deterioration can be significantly monitored via NIRS. However, further studies are needed to determine the role of microcirculation and other predictive factors in the neurocritical management of EBI after aSAH, as these factors can reduce the incidence of adverse outcomes and mortality during hospitalization. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-024-00585-x.

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Section: Discussionmentioning

confidence: 99%

Monitoring of Perioperative Microcirculation Dysfunction by Near-Infrared Spectroscopy for Neurological Deterioration and Prognosis of Aneurysmal Subarachnoid Hemorrhage: An Observational, Longitudinal Cohort Study

Yang,

Tan,

Lin

et al. 2024

Neurol Ther

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“…10.3389/fnins. 2023.1302318 Frontiers in Neuroscience 09 frontiersin.org Scarpino et al, 2020;Nolan et al, 2021;Hoedemaekers et al, 2023), which were associated with poor neurological outcome. The presence of burst suppression was associated with an unfavorable prognosis with 100% specificity (Benarous et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of burst suppression was associated with an unfavorable prognosis with 100% specificity (Benarous et al, 2019). A suppressed EEG was considered as a reliable predictor of poor outcome if it persisted beyond 24 h after the arrest (Hoedemaekers et al, 2023). At 72 h, an isoelectric, suppression, or burst suppression pattern on EEG predicted poor outcome with 100% specificity (Scarpino et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

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Translational Applications of Neuroimaging

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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“…EEG is a key tool in the diagnosis and treatment of epilepsy [17] and a valuable tool for early prognosis in comatose patients with posthypoxic encephalopathy [18]. However, no gold standard has been established for the indications of EEG studies.…”

Section: Discussionmentioning

confidence: 99%

The Role of Routine Electroencephalography in the Diagnosis of Seizures in Medical Intensive Care Units

Hsiao,

Chen,

Chen

et al. 2024

Diagnostics

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Seizures should be diagnosed and treated to ensure optimal health outcomes in critically ill patients admitted in the medical intensive care unit (MICU). Continuous electroencephalography is still infrequently used in the MICU. We investigated the effectiveness of routine EEG (rEEG) in detecting seizures in the MICU. A total of 560 patients admitted to the MICU between October 2018 and March 2023 and who underwent rEEG were reviewed. Seizure-related rEEG constituted 47% of all rEEG studies. Totally, 39% of the patients experienced clinical seizures during hospitalization; among them, 48% experienced the seizure, and 13% experienced their first seizure after undergoing an rEEG study. Seventy-seven percent of the patients had unfavorable short-term outcomes. Patients with cardiovascular diseases were the most likely to have the suppression/burst suppression (SBS) EEG pattern and the highest mortality rate. The rhythmic and periodic patterns (RPPs) and electrographic seizure (ESz) EEG pattern were associated with seizures within 24 h after rEEG, which was also related to unfavorable outcomes. Significant predictors of death were age > 59 years, the male gender, the presence of cardiovascular disease, a Glasgow Coma Scale score ≤ 5, and the SBS EEG pattern, with a predictive performance of 0.737 for death. rEEG can help identify patients at higher risk of seizures. We recommend repeated rEEG in patients with ESz or RPP EEG patterns to enable a more effective monitoring of seizure activities.

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Value of EEG in outcome prediction of hypoxic-ischemic brain injury in the ICU: A narrative review

Cited by 6 publications

References 73 publications

Monitoring of Perioperative Microcirculation Dysfunction by Near-Infrared Spectroscopy for Neurological Deterioration and Prognosis of Aneurysmal Subarachnoid Hemorrhage: An Observational, Longitudinal Cohort Study

Monitoring of Perioperative Microcirculation Dysfunction by Near-Infrared Spectroscopy for Neurological Deterioration and Prognosis of Aneurysmal Subarachnoid Hemorrhage: An Observational, Longitudinal Cohort Study

Translational Applications of Neuroimaging

The Role of Routine Electroencephalography in the Diagnosis of Seizures in Medical Intensive Care Units

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