Consensus on the use of neurophysiological tests in the intensive care unit (ICU): Electroencephalogram (EEG), evoked potentials (EP), and electroneuromyography (ENMG)
| Autor: | Jean-Michel Guerit, K.V. Andersen, M.-D. Lamblin, Y. Péréon, S. Butler, Enrico Facco, Philippe Hantson, A.W. De Weerd, Piero Amodio, Gerhard Litscher, C. Fischer, Aldo Amantini, V. Jäntti |
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| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Brain Death medicine.medical_specialty Critical Care Infant Premature Diseases Neurological disorder Electroencephalography Severity of Illness Index law.invention Epilepsy law Intensive Care Units Neonatal Physiology (medical) Severity of illness medicine Humans Hypnotics and Sedatives Coma Evoked potential Child Hypoxia Brain Intensive care medicine Evoked Potentials Monitoring Physiologic medicine.diagnostic_test Electromyography Electrodiagnosis Infant Newborn Infant Neuromuscular Diseases General Medicine Prognosis medicine.disease Intensive care unit Surgery Intensive Care Units Neurology Brain Injuries Child Preschool Practice Guidelines as Topic Etiology Neurology (clinical) medicine.symptom Psychology Infant Premature |
| Popis: | Summary Study aim To provide a consensus of European leading authorities about the optimal use of clinical neurophysiological (CN) tests (electroencephalogram [EEG]; evoked potentials [EP]; electroneuromyography [ENMG]) in the intensive care unit (ICU) and, particularly, about the way to make these tests clinically useful for the management of individual patients. Methods This study gathered together several European clinical neurophysiologists and neurointensivists whose leading contributions in the adult or paediatric ICU and in continuous neuromonitoring had been peer-acknowledged. It was based on both a literature review and each participant's own experience. Given the methodological impossibility to gather studies fulfilling criteria of evidence-based medicine, this article essentially relies on expert opinions that were gained after several rounds, in which each expert was invited to communicate his own contribution to all other experts. A complete consensus has been reached when submitting the manuscript. Results What the group considered as the best classification systems for EEG and EP abnormalities in the ICU is first presented. CN tests are useful for diagnosis (epilepsy, brain death, and neuromuscular disorders), prognosis (anoxic ischemic encephalopathy, head trauma, and neurologic disturbances of metabolic and toxic origin), and follow-up, in the adult, paediatric, and neonatal ICU. Regarding prognosis, a clear distinction is made between these tests whose abnormalities are indicative of an ominous prognosis and those whose relative normalcy is indicative of a good prognosis. The prognostic significance of any test may vary as a function of coma etiology. Conclusion CN provides quantitative functional assessment of the nervous system. It can be used in sedated or curarized patients. Therefore, it should play a major role in the individual assessment of ICU patients. |
| Databáze: | OpenAIRE |
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