Résumé
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.
Résumé
Objective To observe and evaluate the predictive value of electroencephalogram (EEG) abnormalities of the EEG monitoring of patients with brain dysfunction in the intensive care unit (ICU).Methods Total of 58 cases with brain dysfunction under EEG were collected from the ICU of the XiangYa Hospital,Central South University from January 2014 to December 2015.EEG was performed to monitor those patients and data was collected,analyzed and classified according to both Synek and Young EEG scales to evaluate its predictive value.The statistical analysis was performed with SPSS 23.0 software (MAC,USA) and statistical significant was considered as P ＜0.05.Numerical values were given as means ± SD and t-test was performed to compare data of different groups.Kaplan-Meier survival estimator was used to draw the survival curve,and the survival analysis was postulated by COX regression analysis.Results Data from 58 patients were collected and classified according to both Synek and Young EEG scales,positive waveforms as periodic discharge or delta-predominant background were found among 50 patients,electrographic seizures were found in 7 patients,patients with EEG abnormality possessed a high level of SI00β and showed statistical differences.The 28-day mortahty was independently associated with Acute Physiology and Chronic Health Evaluation (APACHE]] score) (OR:1.08;95％ CI [1.03 to 1.14])、Synek Grade ＞2 (OR:0.17;95％ CI [0.03 to 0.80])、electrographic seizures (OR:23.70;95％ CI [2.02 to 277.73]) and slow rhythm (OR:8.54;95％ CI [1.72 to 42.32]).Conclusions The 28-day mortality of patients under EEG with brain dysfunction was independently associated with Synek Grade ＞ 2,electrographic seizures and slow EEG rhythm.
Résumé
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.