Papaioannou Maria, Vasileiadou Georgia, Soulountsi Vasiliki, Dimaki Anastasia, Bikouli Anastasia, Lavrentieva Athina
Intensive Care Unit, George Papanikolaou General Hospital of Thessaloniki, Thessaloniki, GRC.
Cureus. 2025 May 4;17(5):e83444. doi: 10.7759/cureus.83444. eCollection 2025 May.
In recent years, continuous electroencephalogram (cEEG) monitoring has become a noninvasive tool for detecting and evaluating brain activity in critical care patients. The study aimed to evaluate the impact of cEEG on the management of comatose intensive care unit (ICU) patients and its association with disease prognosis.
This observational, prospective study included adult patients in a single general ICU. The study analyzed patients' demographic characteristics, illness severity using the APACHE II (acute physiology and chronic health evaluation) and SOFA (sequential organ failure assessment) scores, comorbidities, reasons for undertaking EEG, EEG patterns, and therapeutic strategies used. Continuous EEG patterns were correlated with patients' outcomes.
Data from 55 patients were analyzed, with a median age of 61 years (range 19-86), a median APACHE II score of 22 (range 5-38), and a median SOFA score of 9 (range 4-16) on admission. The median duration of mechanical ventilation was 35 days, and the median ICU length of stay (LOS) was 42 days. The majority of cEEGs (61.1%) were performed due to medical reasons (ischemic stroke, septic shock, status epilepticus); 25.9% of cEEGs were conducted in neurosurgical patients with post-traumatic acute brain injury and malignancy, whereas 13% were carried out in post-anoxic comatose patients. Patients who started antiepileptic therapy after EEG examination had a higher mortality rate than patients who had already received antiepileptic drugs (AED) (x=7.9565, p=0.004). In more than half of the patients, an encephalopathic EEG pattern was observed in comparison with a lower percentage of patients who had lateralized periodic discharges (LPDs); one patient had burst suppression, and one patient had electrocerebral inactivity (ECI) or silence (ECS). Patients with epileptic disorders had a higher mortality rate (p=0.018) in comparison with the other categories of patients. Taking their medical comorbidities into consideration, patients diagnosed with diabetes mellitus were more likely to have higher mortality (x=5.115, p=0.024).
The management of critically ill patients is influenced by cEEG, which could modify therapeutic strategies and appears to be a useful prognostic tool in critical care patients.
近年来，连续脑电图（cEEG）监测已成为检测和评估重症监护患者脑活动的一种非侵入性工具。本研究旨在评估cEEG对昏迷重症监护病房（ICU）患者管理的影响及其与疾病预后的关系。
这项观察性前瞻性研究纳入了一家综合性ICU的成年患者。该研究分析了患者的人口统计学特征、使用急性生理与慢性健康状况评估系统（APACHE II）和序贯器官衰竭评估系统（SOFA）评分的疾病严重程度、合并症、进行脑电图检查的原因、脑电图模式以及所采用的治疗策略。连续脑电图模式与患者的预后相关。
分析了55例患者的数据，患者入院时的中位年龄为61岁（范围19 - 86岁），APACHE II评分中位数为22分（范围5 - 38分），SOFA评分中位数为9分（范围4 - 16分）。机械通气的中位持续时间为35天，ICU住院时间（LOS）中位数为42天。大多数cEEG检查（61.1%）是出于医疗原因（缺血性中风、感染性休克、癫痫持续状态）进行的；25.9%的cEEG检查是在患有创伤后急性脑损伤和恶性肿瘤的神经外科患者中进行的，而13%是在缺氧后昏迷患者中进行的。脑电图检查后开始抗癫痫治疗的患者死亡率高于已接受抗癫痫药物（AED）治疗的患者（x = 7.9565，p = 0.004）。超过一半的患者观察到脑病性脑电图模式，相比之下，出现局灶性周期性放电（LPDs）的患者比例较低；1例患者出现爆发抑制，1例患者出现大脑电活动静止（ECI）或电静息（ECS）。与其他类别患者相比，患有癫痫疾病的患者死亡率更高（p = 0.018）。考虑到他们的内科合并症，诊断为糖尿病的患者更有可能具有更高的死亡率（x = 5.115，p = 0.024）。
cEEG会影响重症患者的管理，它可以改变治疗策略，并且似乎是重症监护患者有用的预后工具。
