Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
NewYork Presbyterian Hospital, New York, NY, USA.
Clin Neurophysiol. 2021 Mar;132(3):730-736. doi: 10.1016/j.clinph.2021.01.003. Epub 2021 Jan 20.
To study if limited frontotemporal electroencephalogram (EEG) can guide sedation changes in highly infectious novel coronavirus disease 2019 (COVID-19) patients receiving neuromuscular blocking agent.
98 days of continuous frontotemporal EEG from 11 consecutive patients was evaluated daily by an epileptologist to recommend reduction or maintenance of the sedative level. We evaluated the need to increase sedation in the 6 h following this recommendation. Post-hoc analysis of the quantitative EEG was correlated with the level of sedation using a machine learning algorithm.
Eleven patients were studied for a total of ninety-eight sedation days. EEG was consistent with excessive sedation on 57 (58%) and adequate sedation on 41 days (42%). Recommendations were followed by the team on 59% (N = 58; 19 to reduce and 39 to keep the sedation level). In the 6 h following reduction in sedation, increases of sedation were needed in 7 (12%). Automatized classification of EEG sedation levels reached 80% (±17%) accuracy.
Visual inspection of a limited EEG helped sedation depth guidance. In a secondary analysis, our data supported that this determination may be automated using quantitative EEG analysis.
Our results support the use of frontotemporal EEG for guiding sedation in patients with COVID-19.
研究在使用神经肌肉阻滞剂的高度传染性新型冠状病毒病 2019（COVID-19）患者中，有限的额颞部脑电图（EEG）是否可以指导镇静变化。
由一名癫痫专家对 11 名连续患者的连续额颞部 EEG 进行了 98 天的日常评估，以建议减少或维持镇静水平。我们评估了在建议后的 6 小时内是否需要增加镇静。使用机器学习算法对定量 EEG 进行了回溯分析，并与镇静水平相关联。
共对 11 名患者进行了 98 个镇静日的研究。脑电图在 57 天（58%）中表现为过度镇静，在 41 天（42%）中表现为适当镇静。团队遵循了建议的 59%（N=58；19 例减少，39 例维持镇静水平）。在减少镇静后的 6 小时内，需要增加镇静的有 7 例（12%）。脑电图镇静水平的自动分类达到 80%（±17%）的准确率。
有限脑电图的视觉检查有助于指导镇静深度。在二次分析中，我们的数据支持使用定量 EEG 分析自动进行这种判断。
我们的结果支持使用额颞部 EEG 来指导 COVID-19 患者的镇静。
