Continuous EEG–SEP monitoring of severely brain injured patients in NICU: methods and feasibility

Fossi, S.; Amantini, A.; Grippo, Antonello; Innocenti, P.; Amadori, Andrea; Bucciardini, L.; Cossu, C.; Scarpelli, Serena; Bruni, I.; Sgalla, Roberto; Pinto, Francesco

doi:10.1016/j.neucli.2006.09.001

Cited by 31 publications

(14 citation statements)

References 29 publications

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“…This is the basis of systems designed for continuous monitoring of EEG spectrum, BAEPs and SSEPs (49) or for continuous monitoring of EEG and SSEP (50). In summary, the use of EEG monitoring in patients with ALF admitted in ICU is worth investigating, as EEG is the only tool to monitor seizure activity.…”

Section: Management Of Acute Liver Failurementioning

confidence: 99%

Neurophysiological investigations of hepatic encephalopathy: ISHEN practice guidelines

Guérit¹,

Amantini²,

Fischer³

et al. 2009

Liver International

127

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By studying neuronal activity through neuronal electrogenesis, neurophysiological investigations provide a functional assessment of the nervous system and, therefore, has been used for quantitative assessment and follow-up of hepatic encephalopathy (HE). The different clinical neurophysiological approaches can be classified depending on the function to explore and their sensitivity to HE. The reliable techniques are those that reflect cortical function, i.e., cognitive-evoked potentials (EPs) (P300 paradigm), electroencephalogram (EEG), visual EPs (latency 4 100 ms) and somatosensory EPs (SEPs) (latency between 25 and 100 ms). Short-latency EPs (brainstem acoustic EPs, SEPs of a latency o 25 ms) are in principle insensitive to HE, but can disclose brainstem conduction deficits due to oedema. SEPs and motor EPs can disclose myelopathies. Because of its parallelism to the clinical examination, clinical neurophysiology can complement the neurological examination: (i) to provide evidence of HE in patients who have normal consciousness; (ii) to rule out, at least under some conditions, disturbances of consciousness due to other causes (e.g. drug-induced disturbances, nonconvulsive status epilepticus) with the reservation that the mildest degrees of encephalopathy might be associated with an EEG pattern similar to that induced by drugs; and (iii) to demonstrate the worsening or, conversely improvement, of HE in the follow-up period.By studying neuronal activity through central or peripheral neuronal electrogenesis, neurophysiological investigations provide a functional assessment of the nervous system. Therefore, their domain is similar to that of the clinical examination and complementary to that of neuroimaging. When compared with the clinical examination, they provide a more quantitative assessment, potentially amenable for follow-up, and may remain interpretable in patients under muscle blockade, in whom clinical examination is not feasible.Because neuronal electrogenesis depends on neuronal activity that is sensitive to the influence of energyproviding metabolic systems as well as to the influence of those systems that are involved in electrolyte homoeostasis and clearance of toxic substances, clinical neurophysiology has been used for quantitative assessment and follow-up of metabolic encephalopathies (1). Neurophysiological techniquesTwo techniques are available for routine use, both in clinical and in experimental settings: the electroencephalogram (EEG) and evoked potentials (EPs). Recommendations for their execution are reported by Deuschl and Eisen (2). The grading of recommendations in this article was performed according to the EASL criteria (Table 1).The EEG primarily reflects cortical neuronal activity modulated by both physiological and pathological diencephalic and brainstem influences and by metabolic and toxic factors. Many abnormal EEG patterns are

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Section: Management Of Acute Liver Failurementioning

confidence: 99%

Neurophysiological investigations of hepatic encephalopathy: ISHEN practice guidelines

Guérit¹,

Amantini²,

Fischer³

et al. 2009

Liver International

127

View full text Add to dashboard Cite

show abstract

“…Quality of EEG recording is equivalent to other electrode types, but they are invasive and carry sufficient risk for infection to require replacement every 24-36 h [19]. This is compounded by the fact that they tend to inadvertently fall out beyond that time frame, though application with Dermabond TM adhesive dressing minimizes this issue [19]. Additionally, there is the risk of accidental needle-stick during routine patient care.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, there is the risk of accidental needle-stick during routine patient care. A reported advantage is the ease with which nurses can be taught to replace the needles [19], though this advantage is countered by a system with high stability that does not require frequent replacement for procedures.…”

Section: Discussionmentioning

confidence: 99%

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Sixty Day Continuous Use of Subdermal Wire Electrodes for EEG Monitoring During Treatment of Status Epilepticus

2009

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“…Within the neuroICU continuous EEG (cEEG) monitoring is common and becoming standard of care. cEEG monitoring adds another physiological variable the nurse is able to monitor and potentially use to guide intervention [69]. However, this will require research and consensus on the nurses' role in continuous EEG monitoring.…”

Section: The Nursing Role In Seizure Detection and Managementmentioning

confidence: 99%

Neurocritical Care Nursing Research Priorities

et al. 2011

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The science of nursing has long been discussed as a blending of the art and science of caring, and nursing research builds the evidence of support for nursing practice. Nurses and nursing care are key to successful neurocritical care research endeavors. Ideally nursing care should be evidence based and supported by solid research. The goal of nursing research is to expand the knowledge of caring for patients. Within the scope of nursing research, the priorities for research in neurocritical care should support this goal. In this manuscript, we discuss what we believe are the priorities of neurocritical care nursing research, the obstacles, and some possible solutions.

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Continuous EEG–SEP monitoring of severely brain injured patients in NICU: methods and feasibility

Cited by 31 publications

References 29 publications

Neurophysiological investigations of hepatic encephalopathy: ISHEN practice guidelines

Neurophysiological investigations of hepatic encephalopathy: ISHEN practice guidelines

Sixty Day Continuous Use of Subdermal Wire Electrodes for EEG Monitoring During Treatment of Status Epilepticus

Neurocritical Care Nursing Research Priorities

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