Quantitative Assessment of Electroencephalogram Reactivity in Comatose Patients on Extracorporeal Membrane Oxygenation

Williams, Autumn; Zeng, Yinuo; Thakor, Nitish V.; Geocadin, Romergryko G.; Bronder, Jay; Martinez, Nirma Carballido; Ritzl, Eva K.; Cho, Sung Min

doi:10.1142/s0129065722500253

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…In this pilot study, changes in EEG reactivity induced spectral power changes in specific frequency bands. 63 Furthermore, the use of aEEG is becoming more prominent in ECMO patients. Amplitude-integrated EEG is a convenient, continuous neuromonitoring technique that offers the advantages of 24 hours bedside availability, simpler patient interfaces (cross-cerebral electrodes), and continuous algorithmic data analysis without the need for human expert interpretation.…”

Section: Continuous Neuromonitoring Devicesmentioning

confidence: 99%

Neuromonitoring of Pediatric and Adult Extracorporeal Membrane Oxygenation Patients: The Importance of Continuous Bedside Tools in Driving Neuroprotective Clinical Care

Tabet,

Custer,

Khan

et al. 2023

ASAIO Journal

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Extracorporeal membrane oxygenation (ECMO) is a form of temporary cardiopulmonary bypass for patients with acute respiratory or cardiac failure refractory to conventional therapy. Its usage has become increasingly widespread and while reported survival after ECMO has increased in the past 25 years, the incidence of neurological injury has not declined, leading to the pressing question of how to improve time-to-detection and diagnosis of neurological injury. The neurological status of patients on ECMO is clinically difficult to evaluate due to multiple factors including illness, sedation, and pharmacological paralysis. Thus, increasing attention has been focused on developing tools and techniques to measure and monitor the brain of ECMO patients to identify dynamic risk factors and monitor patients’ neurophysiological state as a function in time. Such tools may guide neuroprotective interventions and thus prevent or mitigate brain injury. Current means to continuously monitor and prevent neurological injury in ECMO patients are rather limited; most techniques provide indirect or postinsult recognition of irreversible brain injury. This review will explore the indications, advantages, and disadvantages of standard-of-care, emerging, and investigational technologies for neurological monitoring on ECMO, focusing on bedside techniques that provide continuous assessment of neurological health.

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Section: Continuous Neuromonitoring Devicesmentioning

confidence: 99%

Neuromonitoring of Pediatric and Adult Extracorporeal Membrane Oxygenation Patients: The Importance of Continuous Bedside Tools in Driving Neuroprotective Clinical Care

Tabet,

Custer,

Khan

et al. 2023

ASAIO Journal

View full text Add to dashboard Cite

show abstract

Assessing consciousness in acute coma using name-evoked responses

Hu,

Chen,

et al. 2024

Brain Research Bulletin

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Methods of Evaluating EEG Reactivity in Adult Intensive Care Units: A Review

Hwang,

Cho,

Geocadin

et al. 2024

Journal of Clinical Neurophysiology

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Purpose: EEG reactivity (EEG-R) has become widely used in intensive care units for diagnosing and prognosticating patients with disorders of consciousness. Despite efforts toward standardization, including the establishment of terminology for critical care EEG in 2012, the processes of testing and interpreting EEG-R remain inconsistent. Methods: A review was conducted on PubMed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria consisted of articles published between January 2012, and November 2022, testing EEG-R on adult intensive care unit patients. Exclusion criteria included articles focused on highly specialized stimulation equipment or animal, basic science, or small case report studies. The Quality In Prognostic Studies tool was used to assess risk of bias. Results: One hundred and five articles were identified, with 26 variables collected for each. EEG-R testing varied greatly, including the number of stimuli (range: 1–8; 26 total described), stimulus length (range: 2–30 seconds), length between stimuli (range: 10 seconds–5 minutes), frequency of stimulus application (range: 1–9), frequency of EEG-R testing (range: 1–3 times daily), EEG electrodes (range: 4–64), personnel testing EEG-R (range: neurophysiologists to nonexperts), and sedation protocols (range: discontinuing all sedation to no attempt). EEG-R interpretation widely varied, including EEG-R definitions and grading scales, personnel interpreting EEG-R (range: EEG specialists to nonneurologists), use of quantitative methods, EEG filters, and time to detect EEG-R poststimulation (range: 1–30 seconds). Conclusions: This study demonstrates the persistent heterogeneity of testing and interpreting EEG-R over the past decade, and contributing components were identified. Further many institutional efforts must be made toward standardization, focusing on the reproducibility and unification of these methods, and detailed documentation in the published literature.

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Quantitative Assessment of Electroencephalogram Reactivity in Comatose Patients on Extracorporeal Membrane Oxygenation

Cited by 4 publications

References 28 publications

Neuromonitoring of Pediatric and Adult Extracorporeal Membrane Oxygenation Patients: The Importance of Continuous Bedside Tools in Driving Neuroprotective Clinical Care

Neuromonitoring of Pediatric and Adult Extracorporeal Membrane Oxygenation Patients: The Importance of Continuous Bedside Tools in Driving Neuroprotective Clinical Care

Assessing consciousness in acute coma using name-evoked responses

Methods of Evaluating EEG Reactivity in Adult Intensive Care Units: A Review

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