床边脑电图在成人重症监护病房治疗性神经肌肉阻滞期间的作用。

Role of bedside electroencephalography in the adult intensive care unit during therapeutic neuromuscular blockade.

作者信息

Crippen D

机构信息

University of Pittsburgh Medical Center, Surgical ICU, St Francis Medical Center, Pittsburgh, PA 15201, USA. crippen+@pitt.edu

出版信息

Crit Care. 1997;1(1):15-24. doi: 10.1186/cc3.

DOI:10.1186/cc3

PMID:11056693

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC28985/

Abstract

BACKGROUND

Size, weight and technical difficulties limit the use of ponderous strip chart electroencephalographs (EEGs) for real time evaluation of brain wave function in modern intensive care units (ICUs). Portable, computer processed, bedside EEGs provide real time brain wave appraisal for some brain functions during therapeutic neuromuscular blockade when the visual clues of the cerebral function disappear. RESULTS: Critically ill ICU patients are frequently placed in suspended animation by neuromuscular blockade to improve hemodynamics in severe organ system failure. Using the portable bedside EEG monitor, several cerebral functions were monitored continuously during sedation of selected patients in our ICU. CONCLUSIONS: The processed EEG is able to continuously monitor the end result of some therapeutics at the neuronal level when natural artifacts are suppressed or eliminated by neuromuscular blockade. Computer processed EEG monitoring may be the only objective method of assessing and controlling sedation during therapeutic musculoskeletal paralysis.

摘要

背景

在现代重症监护病房（ICU）中，笨重的长条图脑电图仪（EEG）的尺寸、重量和技术难题限制了其用于实时评估脑波功能。便携式、计算机处理的床边脑电图仪在治疗性神经肌肉阻滞期间，当脑功能的视觉线索消失时，可为某些脑功能提供实时脑波评估。结果：重症ICU患者常因神经肌肉阻滞而处于假死状态，以改善严重器官系统衰竭时的血流动力学。使用便携式床边脑电图监测仪，在我们ICU中对部分选定患者进行镇静时，连续监测了几种脑功能。结论：当自然伪迹被神经肌肉阻滞抑制或消除时，经处理的脑电图能够在神经元水平上连续监测某些治疗的最终结果。计算机处理的脑电图监测可能是治疗性肌肉骨骼麻痹期间评估和控制镇静的唯一客观方法。