Monitoring cerebral electrical function in the ICU

Stidham, Gregory L.; Nugent, Stephen K.; Rogers, Mark C.

doi:10.1097/00003246-198009000-00008

Cited by 19 publications

(7 citation statements)

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“…Electrocortical activity was monitored throughout the study using a filtered EEG (cerebral function monitor, model 870; Critikon, Tampa, FL) (10). Disk electrodes were placed on the scalp over the frontal and biparietal areas.…”

Section: Methodsmentioning

confidence: 99%

Effects of Pancuronium Bromide on Cerebral Blood Flow Changes during Seizures in Newborn Pigs

et al. 1992

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ABSTRACT. We investigated the effects of pancuronium bromide pretreatment on cerebral blood flow (CBF) during bicuculline-induced seizures in anesthetized piglets. Arterial blood pressure, gases, pH, cerebral electrocortical activity, and CBF (radioactive microsphere) were monitored at baseline, 10 min after administration of pancuronium (0.3 mg/kg i.v.; n = 9) or vehicle (normal saline; n = 8), and again at 5, 15, and 60 rnin after bicuculline (3 mg/ kg i.v.). No change in CBF from baseline was observed at 10 rnin after either saline or pancuronium treatment, before induction of seizures. In the saline group, CBF was 36 f 3 mL. min-' . 100 g-' before bicuculline and increased to 166 k 24 and 205 f 35 mL,min-'.lo0 g-' at 5 and 15 min, respectively, after bicuculline, returning toward baseline by 60 min. In the pancuronium group at 5 min after bicuculline, CBF increased from 45 f 7 to 169 k 26 mL. m i d . 100 g-I, but fell to 88 f 17 mL. min-' . 100 g-' at 15 rnin in contrast to saline-treated piglets. Also, at 15 rnin of seizures, differences between groups were observed in arterial blood pressure, gases, and pH. Although these variables were in the normal range with pancuronium treatment, the saline-treated animals had increased arterial blood pressure (81 k 6 mm Hg) and Pco2 (6 5 0.4 kPa) and decreased Poz (7 2 0.5 kPa) and pH (6.91 f 0.06).Electrocortical activity was abnormal during seizures in both groups. At 60 min, reversal to normal activity was observed in six of nine pancuronium-treated animals versus two of eight saline-treated animals. These data suggest that pancuronium limits cerebral hyperemia during prolonged seizures by attenuating increases in blood pressure as a result of elimination of skeletal muscle activity. This leads to minimal alteration of arterial Pcoz, Poz, and pH during seizures. Supported in part by grants-in-aid from the American Heart AssociationTennessee Afliliate, the National Institutes of Health, and Obstetncs and Gynecology Special Education Fund. 6 dramatic increases in CBF (1). Factors contributing to augmented CBF are increased cerebral metabolic rate (2), metabolic and/or respiratory acidosis (3), and arterial hypertension (4-7). This rise in CBF is also exaggerated by neurogenic mechanisms (8). Babies prone to seizures often have respiratory problems and are given muscle relaxants to ease mechanical ventilation and oxygenation. However, inasmuch as pancuronium therapy has been reported to impair cerebrovascular autoregulation in neonatal animals (9), it is unclear whether such therapy would be beneficial.The purpose of this study was to examine the effects of pancuronium on seizure-induced cerebral hyperemia in newborn pigs. We tested the hypothesis that pancuronium would limit perturbations of arterial blood gases, pH, and blood pressure produced by skeletal muscle activity during prolonged seizures and consequently would limit increases in CBF during seizures. MATERIALS AND METHODSThe animal protocol was reviewed and approved by the Animal Care and Use Committee of Th...

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Section: Methodsmentioning

confidence: 99%

Effects of Pancuronium Bromide on Cerebral Blood Flow Changes during Seizures in Newborn Pigs

et al. 1992

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“…In this respect, incorporation of quantitative EEG techniques or digital trend analysis (DTA) methods into routine monitoring might be a step in the right direction (Kurtz et al, 2009;Scheuer and Wilson, 2004;Stidham et al, 1980). Ictal events are typically characterized by prominent changes in the frequency and amplitude of EEG activity as compared to baseline, and therefore can be detected on the spectral display of quantitative EEG methods such as amplitude integrated EEG (aEEG) and density spectral array (DSA) or compressed spectral array (CSA).…”

Section: Introductionmentioning

confidence: 99%

“…These techniques provide continuous on-line or real-time spectrographic display of trends in cerebral electrical activity at the bedside. Of note, in aEEG, the information from one channel is rectified, filtered, time compressed and displayed on a semi-logarithmic scale (El-Dib et al, 2009;Prior et al, 1971;Stidham et al, 1980;Toet and Lemmers, 2009), whereas in CSA or DSA fast-Fourier transformation is applied to convert raw EEG into time-compressed and color-coded display (Bickford et al, 1973;Salinsky et al, 1987;Scheuer and Wilson, 2004). Spectrogram screening has been shown to significantly reduce EEG review time, with minimal loss of sensitivity (Moura et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Non-expert use of quantitative EEG displays for seizure identification in the adult neuro-intensive care unit

et al. 2015

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“…On the other hand, the same guidelines state that a smaller number of electrodes might be appropriate for special circumstances 35. Although not considered to be comprehensive, limited channels have been used in EEG recordings to detect seizures in the intensive care unit and in experimental settings 22 36 37. In addition, abbreviated hairline EEG with self-adhesive electrodes and fewer than the recommended 16 channels has been performed as an emergency procedure in neurological institutions in recent years 24 38.…”

Section: Discussionmentioning

confidence: 99%

“…Literature on single-channel EEG monitoring of epileptic seizures is limited to neonatological studies 37 40–42. The number of channels that is indicated for monitoring infants is still under debate, although there seems to be good agreement between one-channel recording and two-channel recording 42.…”

Section: Discussionmentioning

confidence: 99%

Single-channel electroencephalography of epileptic seizures in the out-of-hospital setting: an observational study

et al. 2011

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Monitoring cerebral electrical function in the ICU

Cited by 19 publications

References 0 publications

Effects of Pancuronium Bromide on Cerebral Blood Flow Changes during Seizures in Newborn Pigs

Effects of Pancuronium Bromide on Cerebral Blood Flow Changes during Seizures in Newborn Pigs

Non-expert use of quantitative EEG displays for seizure identification in the adult neuro-intensive care unit

Single-channel electroencephalography of epileptic seizures in the out-of-hospital setting: an observational study

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