Utilidad del monitoreo continuo del electroencefalograma en el paciente crítico / Utility of continuous electroencephalogram monitoring in the critical patients

Introducción: El monitoreo continuo del Electroencefalograma, es la recogida simultánea de la actividad cerebral y la conducta clínica por un período de horas a días. Por el alto costo de la técnica aún no está muy difundida. Objetivos: Evaluar la utilidad del monitoreo electroencefalográfico continuo en el paciente crítico. Métodos: Se realizó un estudio descriptivo, retrospectivo y longitudinal en 118 sujetos mayores de 19 años ingresados en las unidades de terapia del Hospital Clínico Quirúrgico Hermanos Ameijeiras; entre noviembre 2016 a octubre 2018 con indicación de un Electroencefalograma continuo. Se consideraron variables clínicas y electroencefalográficas: escala de Glasgow, ocurrencia de crisis, diagnóstico, estado al egreso, anormalidad del Electroencefalograma, descargas epileptiformes, sospecha de estatus epiléptico no convulsivo por electroencefalograma entre otras. Los datos se procesaron con test de Chi cuadrado, test de Mc Nemar y test t de student, se empleó un nivel de significación de p≤0.05. Resultados: 60 de los pacientes pertenecían al sexo femenino, la mediana de las edades fue 67,5 años. La escala de Glasgow mostró asociación significativa con el grado de anormalidad del electroencefalograma (p=0,001), es la arreactividad y la discontinuidad de la actividad de base predictores de pobre pronóstico. Se observaron descargas epileptiformes periódicas en 100 pacientes. Se definió estatus epiléptico no convulsivo en 56 sujetos (37,28 por ciento) y en 81 sujetos (68,64 por ciento) el resultado del electroencefalograma motivó una conducta médica. Conclusiones: El monitoreo continuo del electroencefalograma es útil en el diagnóstico y manejo del paciente con episodios no convulsivos, permite formular un pronóstico neurológico y orientó la conducta médica(AU)

Introduction: The continuous monitoring of the electroencephalogram is the simultaneous collection of brain activity and clinical behavior for a period of hours to days. Due to the high cost of the technique, it is not yet widely used. Objectives: To evaluate the usefulness of continuous electroencephalographic monitoring in critically ill patients. Methods: A descriptive, retrospective and longitudinal study was carried out in 118 subjects over 19 years of age admitted to the therapy units at Hermanos Ameijeiras Surgical Clinical Hospital; from November 2016 to October 2018. They were indicated a continuous electroencephalogram. Clinical and electroencephalographic variables were considered, such as Glasgow scale, seizure occurrence, diagnosis, discharge status, electroencephalogram abnormality, epileptiform discharges, suspicion of nonconvulsive status epilepticus by electroencephalogram, among others. The data was processed with the Chi square test, the Mc Nemar test and the student's t test, using significance level of p≤0.05. Results: Sixty patients were female, the median age was 67.5 years. The Glasgow scale showed significant association with the degree of electroencephalogram abnormality (p=0.001). A reactivity and discontinuity of baseline activity are predictors of poor prognosis. Periodic epileptiform discharges were observed in 100 patients. Non-convulsive status epilepticus was defined in 56 subjects (37.28 percent) and in 81 subjects (68.64 percent) the result of the electroencephalogram motivated a medical procedure. Conclusions: The continuous monitoring of the electroencephalogram is useful in the diagnosis and management of patients with non-convulsive episodes, it allows formulating a neurological prognosis and guided medical conduct(AU)

Application of continuous electroencephalography monitoring in patients with severe brain injuries / 中国实用内科杂志

Continuous electroencephalography is an indispensable part of multi-mode monitoring of neurological function in severe patients as a non-invasive,bedside,continuous and real-time monitoring method.The purpose and indications for CEEG includes non-convulsive seizure and non-convulsive seizure status detection,monitoring the effects of treatment(including sedative and anti-epileptic drugs),to evaluate cerebral blood flow,grading and classification of EEG abnormalities and prognostication.Since the application of CEEG in critical patients is in its infancy,the standardization such as number of electrodes and duration,as well as the pathological and therapeutic significance of various abnormal EEG changes,still needs to be further studied.However,there is no doubt that CEEG is of great helpful for physicians to detect brain dysfunction early to carry out intervention and dynamic monitoring,as well as to make prognostication.It is always indispensable in the management of severe neurological patients and is worthy of attention.

Application of electroencephalogram in pediatric intensive care / 中国小儿急救医学

Continuous electroencephalogram(cEEG) was used to evaluate the degree and prognosis of brain function injury, to find epileptic seizures and non-convulsive status epilepticus, to monitor the response of anticonvulsant drugs and hypothermia,and to identify non-epileptic events in coma patients in ICU. The condition of critical children in PICU is more complex, and the interpretation of cEEG results requires the full communication and close cooperation between neuroelectrophysiological professionals and ICU doctors. Amplitude integrated electroencephalogram is a real-time and intuitive method,which is relative-ly easy to be grasped by the PICU staff and help to timely detection and treatment of some severe illness change,so it is an important supplement to cEEG,but cannot replace the original EEG analysis.

Bedside electroencephalogram monitoring / 中国小儿急救医学

Brain injury is one of the most common diseases in PICU.Bedside electroencephalogram monitoring is the most commonly used to evaluate cerebral function.Bedside electroencephalogram monitoring includes continuous electroencephalogram,video electroencephalogram and cerebral function trends,such as amplitude integrated electroencephalogram,envelope and band power.