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[重症监护病房中的脑电图:哪些适应症,使用哪些设备?]

[EEG in intensive care unit: which indications, which material?].

作者信息

Velly L, Pellegrini L, Bruder N

机构信息

Pôle anesthésie-réanimation, CHU Timone Adultes, 264, rue Saint-Pierre, 13385 Marseille, France.

出版信息

Ann Fr Anesth Reanim. 2012 Jun;31(6):e145-53. doi: 10.1016/j.annfar.2012.04.019. Epub 2012 Jun 9.

Abstract

There is a growing development of continuous EEG monitoring (cEEG) in the intensive care unit (ICU) management of neurological patients. Its main objective is the detection of epileptic seizures or status epilepticus because the sensitivity of standard short-duration EEG recording in the ICU is poor. The aim of monitoring is to allow rapid recognition and treatment of epileptic complications in order to decrease secondary insults to the brain and improve outcome. Several studies have demonstrated that a large proportion of patients has epileptic crisis after subarachnoid haemorrhage, stroke or brain trauma, without any clinical manifestation. The EEG feature has also demonstrated a prognosis value but its value for clinical management needs further studies. Another application of EEG in the ICU is monitoring depth of anaesthesia or barbiturate treatment. Due to artifacts contamination, this is possible only in deeply sedated of paralyzed patients. The impact or cEEG monitoring on clinical management and its indications have to be further defined.

摘要

在神经科患者的重症监护病房(ICU)管理中,持续脑电图监测(cEEG)的应用正在不断发展。其主要目的是检测癫痫发作或癫痫持续状态,因为ICU中标准的短程脑电图记录的敏感性较差。监测的目的是能够快速识别和治疗癫痫并发症,以减少对大脑的继发性损伤并改善预后。多项研究表明,很大一部分患者在蛛网膜下腔出血、中风或脑外伤后会出现癫痫危机,但没有任何临床表现。脑电图特征也已显示出预后价值,但其在临床管理中的价值仍需进一步研究。脑电图在ICU中的另一个应用是监测麻醉深度或巴比妥类药物治疗。由于存在伪迹干扰,这仅在深度镇静或瘫痪的患者中可行。cEEG监测对临床管理的影响及其适应证仍有待进一步明确。

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