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脓毒症患者脑电图异常与计算得出的预后评分的相关性:病例系列

Electroencephalographic Abnormalities in Sepsis Patients in Correlation to the Calculated Prognostic Scores: A Case Series.

作者信息

Velissaris Dimitrios, Pantzaris Nikolaos-Dimitrios, Skroumpelou Anastasia, Polychronopoulos Panagiotis, Karamouzos Vasilios, Pierrakos Charalampos, Gogos Charalampos, Karanikolas Menelaos

机构信息

Internal Medicine Department, University Hospital of Patras, Patras Greece.

Neurology Department, University Hospital of Patras, Patras Greece.

出版信息

J Transl Int Med. 2018 Dec 31;6(4):176-180. doi: 10.2478/jtim-2018-0032. eCollection 2018 Dec.

Abstract

OBJECTIVE

To evaluate the electroencephalographic (EEG) findings and correlate EEG findings with inflammatory biomarkers and the sepsis prognostic scores SOFA, SAPS II and APACHE II in patients who present in the Emergency Department with sepsis without clinical central nervous system involvement.

METHODS

The study included seventeen patients (< 70 years old) with sepsis without central nervous system involvement presenting in the Emergency Department of the University Hospital of Patras, Greece. All patients underwent neurologic examination and EEG analysis on admission to the hospital and were treated according to the international guideline protocols for sepsis.

RESULTS

Six of seventeen sepsis patients had mild or moderate EEG abnormalities. We did not find any significant correlation between EEG abnormalities and inflammatory biomarkers (CRP, WBC) or commonly used prognostic sepsis scores.

CONCLUSIONS

EEG could serve as a useful tool to identify brain alterations at an early stage in sepsis, before clinical sings of encephalopathy can be detected. However, the presence of EEG abnormalities does not correlate with sepsis severity as measured by the commonly used prognostic sepsis scores SOFA, APACHE II or SAPS II. Because this was a small single center observational study, large multi-center studies are warranted to confirm these findings.

摘要

目的

评估在急诊科就诊的无临床中枢神经系统受累的脓毒症患者的脑电图(EEG)表现,并将EEG表现与炎症生物标志物以及脓毒症预后评分序贯器官衰竭评估(SOFA)、简化急性生理学评分II(SAPS II)和急性生理与慢性健康状况评分II(APACHE II)进行关联分析。

方法

该研究纳入了17例(年龄<70岁)在希腊帕特雷大学医院急诊科就诊的无中枢神经系统受累的脓毒症患者。所有患者在入院时均接受了神经系统检查和EEG分析,并按照脓毒症的国际指南方案进行治疗。

结果

17例脓毒症患者中有6例存在轻度或中度EEG异常。我们未发现EEG异常与炎症生物标志物(CRP、白细胞)或常用的脓毒症预后评分之间存在任何显著相关性。

结论

EEG可作为一种有用的工具,在脓毒症患者出现脑病临床体征之前早期识别脑部改变。然而,EEG异常的存在与常用的脓毒症预后评分SOFA、APACHE II或SAPS II所衡量的脓毒症严重程度无关。由于这是一项小型单中心观察性研究,因此需要进行大型多中心研究来证实这些发现。

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