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Titolo:
Electroencephalogram silence ratio for early outcome prognosis in severe head trauma
Autore:
Theilen, HJ; Ragaller, M; Tscho, U; May, SA; Schackert, G; Albrecht, WD;
Indirizzi:
Tech Univ Dresden, Univ Hosp, Dept Anesthesiol, D-8027 Dresden, Germany Tech Univ Dresden Dresden Germany D-8027 hesiol, D-8027 Dresden, Germany Tech Univ Dresden, Univ Hosp, Dept Neurosurg, D-8027 Dresden, Germany TechUniv Dresden Dresden Germany D-8027 rosurg, D-8027 Dresden, Germany
Titolo Testata:
CRITICAL CARE MEDICINE
fascicolo: 10, volume: 28, anno: 2000,
pagine: 3522 -
SICI:
0090-3493(200010)28:10<3522:ESRFEO>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
SOMATOSENSORY-EVOKED-POTENTIALS; INTRACRANIAL HYPERTENSION; INJURED PATIENTS; BRAIN-DAMAGE; EEG; COMA; MANAGEMENT; PATTERNS; PREDICTION; MIDAZOLAM;
Keywords:
head trauma; outcome; processed electroencephalogram; neuromonitoring; electroencephatogram-silence ratio; somatosensory evoked potentials; brainstem evoked potentials;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Theilen, HJ Tech Univ Dresden, Univ Klinikum Carl Gustav Carus, Klin & Poliklin Anasthesiol & Intens Therapie, Fetscherstasse 74, D-01307 Dresden, Germany Tech Univ Dresden Fetscherstasse 74 Dresden Germany D-01307 y
Citazione:
H.J. Theilen et al., "Electroencephalogram silence ratio for early outcome prognosis in severe head trauma", CRIT CARE M, 28(10), 2000, pp. 3522

Abstract

Objective: To introduce the electroencephalogram silence-ratio (ESR) as a variable derived from mathematically processed electroencephalogram for early outcome prognosis in patients with severe head trauma and to comparatively assess sensitivity, specificity and predictive value vs. somatosensory evoked potentials and brainstem auditory evoked potentials. Design: Prospective, Interventional study. Setting: Intensive care unit of a university hospital. Patients: A total of 32 adults with severe acute head trauma (Glasgow ComaScale score less than or equal to 8). Methods and Main Results: In all patients, electroencephalographic recording was continuously performed by frontomastoid electrode montage for 24-96 hrs after admission to the ICU. The data were subsequently computed by fastFourier analysis and the ESR (intervals of suppression as periods >240 msecs during which the electroencephalographic voltage did not exceed 5 mu V) was displayed and recorded an a computer for further evaluation. Somatosensory evoked potentials and brainstem auditory evoked potentials were elicited during the first 2 days after admission. Outcome evaluation was performed6 months after trauma using the Glasgow Outcome Scale and the Rappaport Disability Rating Scale. After careful artifact exclusion, the ESR depicted the highest sensitivity, specificity, and positive predictive value comparedwith evoked potentials. Even a highly significant correlation between outcome and ESR was found (p < .0001). Conclusion: The ESR is a valuable variable showing a high reliability withrespect to outcome prediction in severe head trauma with a higher predictive value than short latency somatosensory evoked potentials. Evidence exists that the ESR provides at least partial information regarding adequate cerebral oxygen delivery.

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Documento generato il 03/08/20 alle ore 12:51:11