Electroencephalography of mechanically ventilated patients at high risk of delirium.

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State: Public
Version: author
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_46E6993F88E4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Electroencephalography of mechanically ventilated patients at high risk of delirium.
Journal
Acta neurologica Scandinavica
Author(s)
Eskioglou E., Iaquaniello C., Alvarez V., Rüegg S., Schindler K., Rossetti A.O., Oddo M.
ISSN
1600-0404 (Electronic)
ISSN-L
0001-6314
Publication state
Published
Issued date
09/2021
Peer-reviewed
Oui
Volume
144
Number
3
Pages
296-302
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
Neurophysiological exploration of ICU delirium is limited. Here, we examined EEG characteristics of medical-surgical critically ill patients with new-onset altered consciousness state at high risk for ICU delirium.
Pre-planned analysis of non-neurological mechanically ventilated medical-surgical ICU subjects, who underwent a prospective multicenter randomized, controlled EEG study (NCT03129438, April 2017-November 2018). EEG characteristics, according to the 2012 ACNS nomenclature, included background activity, rhythmic periodic patterns/epileptic activity, amplitude, frequency, stimulus-induced discharges, triphasic waves, reactivity, and NREM sleep. We explored EEG findings in delirious versus non-delirious patients, specifically focusing on the presence of burst-suppression and rhythmic periodic patterns (ictal-interictal continuum), and ictal activity.
We analyzed 91 patients (median age, 66 years) who underwent EEG because of new-onset altered consciousness state at a median 5 days from admission; 42 patients developed delirium (46%). Burst-suppression (10 vs 0%, p = .02), rhythmic/periodic patterns (43% vs 22%, p = .03) and epileptiform activity (7 vs 0%, p = .05) were more frequent in delirious versus non-delirious patients. The presence of at least one of these abnormal EEG findings (32/91 patients; 35%) was associated with a significant increase in the likelihood of delirium (42 vs 15%, p = .006). Cumulative dose of sedatives and analgesics, as well as all other EEG characteristics, did not differ significantly between the two groups.
In mechanically ventilated non-neurological critically ill patients with new-onset alteration of consciousness, EEG showing burst-suppression, rhythmic or periodic patterns, or seizures/status epilepticus indicate an increased risk of ICU delirium.
Keywords
Aged, Delirium/diagnosis, Delirium/epidemiology, Electroencephalography, Epilepsy, Female, Humans, Prospective Studies, Respiration, Artificial/adverse effects, EEG, critical care, delirium
Pubmed
Web of science
Open Access
Yes
Create date
11/05/2021 12:57
Last modification date
23/10/2021 6:38
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