Document Detail


Quantitative multichannel EEG measure predicting the optimal weaning from ventilator in ICU patients with acute respiratory failure.
MedLine Citation:
PMID:  16495143     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to develop a novel quantitative multichannel EEG (qEEG) based analysis method, called Global Field Damping Time (GFDT), in order to detect potential EEG changes of patients admitted to the ICU with acute respiratory failure, and correlate them to the patients' recovery outcome predicting the optimal time-point to disconnect the patient from mechanical ventilation. METHODS: Twenty-nine adult patients with acute respiratory failure out of 98 admitted to the Intensive Care Unit of Saint Paul General Hospital were enrolled, and among them only 15 completed the study. The patients were classified in 3 groups according to their outcome after 3 months follow-up. The patients were intubated with fraction of inspired oxygen (FiO2) of 100%. Neurological Deficit Scores (NDS) were measured 24 h after intubation to assess patients' neurological condition. Twenty-four hours after patient's intubation, FiO2 was decreased to 40% (weaning session), followed by a 5 min early recovery session, a 5 min recovery 1 session and a 5 min recovery 2 session. EEG recordings were performed during this experimental procedure. Multichannel EEG segments were processed and fitted into a multivariate autoregressive (mAR) model, and single channel EEG segments into a scalar autoregressive (sAR) model. The mAR and the sAR models of arbitrary order p were decomposed into mp and p oscillators and relaxators, respectively. Damping time of each oscillator and each relaxator, and the Global Field Damping Time (GFDT) as a weighted damping time were estimated for both mAR and sAR models. RESULTS: A statistically significant increase of mAR model's GFDT during the weaning session was observed in the subjects of all groups. Comparing the 3 patients' groups, statistically significant differences for mAR model's GFDT were observed for the weaning and early recovery session. Linear regression analysis between NDS and mean mAR model's GFDT showed statistical significance during weaning session, early recovery session, and recovery 1 session. There was no statistical significance for SaO2 in the regression analysis with NDS. The sAR model's GFDT presented worst results in comparison with the mAR modelling GFDT in the identification of hypoxic conditions during weaning session and in the discrimination of patients with acute respiratory failure according to their neurological outcome. CONCLUSIONS: Global Field Damping Time as correlated to the patients' neurological outcome appears to be a simple, compact, and substantial novel indicator of cerebral hypoxia and a potential predictor of the optimal time-point to disconnect the patient from the ventilator. SIGNIFICANCE: Quantitative EEG seems to be an important tool for ICU clinicians assisting them to decide for the patients' optimal time-point to disconnect the patient from the ventilator.
Authors:
Christos Papadelis; Nikos Maglaveras; Chrysoula Kourtidou-Papadeli; Panagiotis Bamidis; Maria Albani; Kyriazis Chatzinikolaou; Konstantinos Pappas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-02-21
Journal Detail:
Title:  Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology     Volume:  117     ISSN:  1388-2457     ISO Abbreviation:  Clin Neurophysiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-20     Completed Date:  2006-06-08     Revised Date:  2008-09-10    
Medline Journal Info:
Nlm Unique ID:  100883319     Medline TA:  Clin Neurophysiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  752-70     Citation Subset:  IM    
Affiliation:
Laboratory of Medical Informatics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece. christos@med.auth.gr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease / rehabilitation
Aged
Aged, 80 and over
Biological Clocks
Brain / physiopathology
Electroencephalography / methods*,  standards
Female
Humans
Hypoxia-Ischemia, Brain / diagnosis*,  physiopathology,  prevention & control
Intensive Care Units / standards,  trends
Male
Middle Aged
Models, Neurological
Models, Statistical
Monitoring, Physiologic / methods,  standards
Predictive Value of Tests
Regression Analysis
Respiration, Artificial* / adverse effects
Respiratory Insufficiency / complications,  physiopathology*,  therapy
Time Factors
Ventilator Weaning / methods,  standards*

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