Jolien Haesen1, Ward Eertmans2, Cornelia Genbrugge3, Ingrid Meex4, Jelle Demeestere5, Margot Vander Laenen6, Willem Boer7, Dieter Mesotten8, Jo Dens9, Frank Jans10, Ludovic Ernon11, Cathy De Deyne12. 1. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: jolien.haesen@student.kuleuven.be. 2. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: ward.eertmans@uhasselt.be. 3. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: cornelia.genbrugge@uhasselt.be. 4. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: ingrid.meex@zol.be. 5. Department of Neurology, University Hospitals Leuven, Herestraat 49, 3600 Leuven, Belgium. Electronic address: jelle.demeestere@kuleuven.be. 6. Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: margot.vanderlaenen@zol.be. 7. Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: willem.boer@zol.be. 8. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: dieter.mesotten@zol.be. 9. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Cardiology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: jo.dens@zol.be. 10. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: frank.jans@zol.be. 11. Department of Neurology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: ludovic.ernon@zol.be. 12. Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium; Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium. Electronic address: cathy.dedeyne@zol.be.
Abstract
AIMS: We aimed to validate retrospectively the accuracy of simplified electroencephalography (EEG) monitoring derived from the bispectral index (BIS) monitor in post-cardiac arrest (CA) patients. METHODS: Successfully resuscitated CA patients were transferred to the Catherization Lab followed by percutaneous coronary intervention when indicated. On arrival at the coronary care unit, bilateral BIS monitoring was started and continued up to 72 h. Raw simplified EEG tracings were extracted from the BIS monitor at a time point coinciding with the registration of standard EEG monitoring. BIS EEG tracings were reviewed by two neurophysiologists, who were asked to indicate the presence of following patterns: diffuse slowing rhythm, burst suppression pattern, cerebral inactivity, periodic epileptiform discharges and status epilepticus (SE). Additionally, these simplified BIS EEG tracings were analysed by two inexperienced investigators, who were asked to indicate the presence of SE only. RESULTS: Thirty-two simplified BIS EEG samples were analysed. Compared to standard EEG, neurophysiologists interpreted all simplified EEG samples with a sensitivity of 86%, a specificity of 100% and an interobserver variability of 0.843. Furthermore, SE was identified with a sensitivity of 80% and a specificity of 94% by two unexperienced physicians. CONCLUSION: Using a simple classification system, raw simplified EEG derived from a BIS monitoring device is comparable to standard EEG monitoring. Moreover, investigators without EEG experience were capable to identify SE in post-CA patients. Future studies will be warranted to confirm our results and to determine the added value of using simplified BIS EEG in terms of prognostic and therapeutic implications.
AIMS: We aimed to validate retrospectively the accuracy of simplified electroencephalography (EEG) monitoring derived from the bispectral index (BIS) monitor in post-cardiac arrest (CA) patients. METHODS: Successfully resuscitated CA patients were transferred to the Catherization Lab followed by percutaneous coronary intervention when indicated. On arrival at the coronary care unit, bilateral BIS monitoring was started and continued up to 72 h. Raw simplified EEG tracings were extracted from the BIS monitor at a time point coinciding with the registration of standard EEG monitoring. BIS EEG tracings were reviewed by two neurophysiologists, who were asked to indicate the presence of following patterns: diffuse slowing rhythm, burst suppression pattern, cerebral inactivity, periodic epileptiform discharges and status epilepticus (SE). Additionally, these simplified BIS EEG tracings were analysed by two inexperienced investigators, who were asked to indicate the presence of SE only. RESULTS: Thirty-two simplified BIS EEG samples were analysed. Compared to standard EEG, neurophysiologists interpreted all simplified EEG samples with a sensitivity of 86%, a specificity of 100% and an interobserver variability of 0.843. Furthermore, SE was identified with a sensitivity of 80% and a specificity of 94% by two unexperienced physicians. CONCLUSION: Using a simple classification system, raw simplified EEG derived from a BIS monitoring device is comparable to standard EEG monitoring. Moreover, investigators without EEG experience were capable to identify SE in post-CA patients. Future studies will be warranted to confirm our results and to determine the added value of using simplified BIS EEG in terms of prognostic and therapeutic implications.
Authors: Edilberto Amorim; Shirley S Mo; Sebastian Palacios; Mohammad M Ghassemi; Wei-Hung Weng; Sydney S Cash; Matthew T Bianchi; M Brandon Westover Journal: Neurology Date: 2020-07-13 Impact factor: 9.910