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成人重症监护病房(ICU)中的脑电图连续监测。

Continuous EEG monitoring in adults in the intensive care unit (ICU).

作者信息

André-Obadia N, Parain D, Szurhaj W

机构信息

Service de neurophysiologie et d'épileptologie, hôpital Neurologique P.-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France; Inserm U 1028, NeuroPain team, centre de recherche en neuroscience de Lyon (CRNL), université Lyon 1, 69677 Bron cedex, France.

Service de neurophysiologie clinique, CHU Charles-Nicolle, 76031 Rouen cedex, France.

出版信息

Neurophysiol Clin. 2015 Mar;45(1):39-46. doi: 10.1016/j.neucli.2014.11.003. Epub 2015 Jan 15.

Abstract

Continuous EEG monitoring in the ICU is different from planned EEG due to the rather urgent nature of the indications, explaining the fact that recording is started in certain cases by the clinical team in charge of the patient's care. Close collaboration between neurophysiology teams and intensive care teams is essential. Continuous EEG monitoring can be facilitated by quantified analysis systems. This kind of analysis is based on certain signal characteristics, such as amplitude or frequency content, but raw EEG data should always be interpreted if possible, since artefacts can sometimes impair quantified EEG analysis. It is preferable to work within a tele-EEG network, so that the neurophysiologist has the possibility to give an interpretation on call. Continuous EEG monitoring is thus useful in the diagnosis of non-convulsive epileptic seizures or purely electrical discharges and in the monitoring of status epilepticus when consciousness disorders persist after initial treatment. A number of other indications are currently under evaluation.

摘要

重症监护病房(ICU)中的连续脑电图监测与计划脑电图不同,因为其适应证性质较为紧急,这就解释了为何在某些情况下由负责患者护理的临床团队启动记录。神经生理学团队与重症监护团队之间的密切合作至关重要。量化分析系统有助于进行连续脑电图监测。这种分析基于某些信号特征,如振幅或频率成分,但只要有可能,原始脑电图数据都应进行解读,因为伪迹有时会影响量化脑电图分析。最好在远程脑电图网络内开展工作,以便神经生理学家能够随时进行解读。因此,连续脑电图监测在非惊厥性癫痫发作或纯放电的诊断以及在初始治疗后意识障碍持续存在时的癫痫持续状态监测中很有用。目前正在评估一些其他适应证。

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