PMID- 35997792 OWN - NLM STAT- MEDLINE DCOM- 20220914 LR - 20231002 IS - 1432-1238 (Electronic) IS - 0342-4642 (Print) IS - 0342-4642 (Linking) VI - 48 IP - 10 DP - 2022 Oct TI - Electroencephalogram in the intensive care unit: a focused look at acute brain injury. PG - 1443-1462 LID - 10.1007/s00134-022-06854-3 [doi] AB - Over the past decades, electroencephalography (EEG) has become a widely applied and highly sophisticated brain monitoring tool in a variety of intensive care unit (ICU) settings. The most common indication for EEG monitoring currently is the management of refractory status epilepticus. In addition, a number of studies have associated frequent seizures, including nonconvulsive status epilepticus (NCSE), with worsening secondary brain injury and with worse outcomes. With the widespread utilization of EEG (spot and continuous EEG), rhythmic and periodic patterns that do not fulfill strict seizure criteria have been identified, epidemiologically quantified, and linked to pathophysiological events across a wide spectrum of critical and acute illnesses, including acute brain injury. Increasingly, EEG is not just qualitatively described, but also quantitatively analyzed together with other modalities to generate innovative measurements with possible clinical relevance. In this review, we discuss the current knowledge and emerging applications of EEG in the ICU, including seizure detection, ischemia monitoring, detection of cortical spreading depolarizations, assessment of consciousness and prognostication. We also review some technical aspects and challenges of using EEG in the ICU including the logistics of setting up ICU EEG monitoring in resource-limited settings. CI - (c) 2022. Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Alkhachroum, Ayham AU - Alkhachroum A AD - Department of Neurology, University of Miami, Miami, FL, USA. AD - Department of Neurology, Jackson Memorial Hospital, Miami, FL, USA. FAU - Appavu, Brian AU - Appavu B AD - Department of Child Health and Neurology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA. AD - Department of Neurosciences, Phoenix Children's Hospital, Phoenix, AZ, USA. FAU - Egawa, Satoshi AU - Egawa S AD - Neurointensive Care Unit, Department of Neurosurgery, and Stroke and Epilepsy Center, TMG Asaka Medical Center, Saitama, Japan. FAU - Foreman, Brandon AU - Foreman B AD - Department of Neurology and Rehabilitation Medicine, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH, USA. FAU - Gaspard, Nicolas AU - Gaspard N AD - Department of Neurology, Erasme Hospital, Free University of Brussels, Brussels, Belgium. FAU - Gilmore, Emily J AU - Gilmore EJ AD - Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA. AD - Neurocritical Care and Emergency Neurology, Department of Neurology, Ale University School of Medicine, New Haven, CT, USA. FAU - Hirsch, Lawrence J AU - Hirsch LJ AD - Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA. FAU - Kurtz, Pedro AU - Kurtz P AD - Department of Intensive Care Medicine, D'or Institute for Research and Education, Rio de Janeiro, Brazil. AD - Neurointensive Care, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil. FAU - Lambrecq, Virginie AU - Lambrecq V AD - Department of Clinical Neurophysiology and Epilepsy Unit, AP-HP, Pitie Salpetriere Hospital, Reference Center for Rare Epilepsies, 75013, Paris, France. FAU - Kromm, Julie AU - Kromm J AD - Departments of Critical Care Medicine and Clinical Neurosciences, Cumming School of Medicine, Calgary, AB, Canada. AD - Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, AB, Canada. FAU - Vespa, Paul AU - Vespa P AD - Brain Injury Research Center, Department of Neurosurgery, University of California, Los Angeles, USA. FAU - Zafar, Sahar F AU - Zafar SF AD - Department of Neurology, Massachusetts General Hospital, Boston, MA, USA. FAU - Rohaut, Benjamin AU - Rohaut B AD - Department of Neurology, Sorbonne Universite, Pitie-Salpetriere-AP-HP and Paris Brain Institute, ICM, Inserm, CNRS, Paris, France. FAU - Claassen, Jan AU - Claassen J AUID- ORCID: 0000-0002-5893-8531 AD - Department of Neurology, Neurological Institute, Columbia University, New York Presbyterian Hospital, 177 Fort Washington Avenue, MHB 8 Center, Room 300, New York, NY, 10032, USA. jc1439@columbia.edu. LA - eng GR - R01 NS106014/NS/NINDS NIH HHS/United States GR - R01 NS117904/NS/NINDS NIH HHS/United States GR - K23 NS126577/NS/NINDS NIH HHS/United States GR - K23 NS114201/NS/NINDS NIH HHS/United States GR - R03 NS112760/NS/NINDS NIH HHS/United States GR - UL1 TR001863/TR/NCATS NIH HHS/United States GR - UL1 TR002736/TR/NCATS NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20220823 PL - United States TA - Intensive Care Med JT - Intensive care medicine JID - 7704851 SB - IM MH - *Brain Injuries/diagnosis MH - Electroencephalography MH - Humans MH - Intensive Care Units MH - Seizures/diagnosis MH - *Status Epilepticus/diagnosis PMC - PMC10008537 MID - NIHMS1874105 OTO - NOTNLM OT - Cortical spreading depolarization OT - Disorders of consciousness OT - Electroencephalogram OT - Intensive care unit OT - Ischemia OT - Nonconvulsive seizures OT - Status epilepticus COIS- Conflict of interest AA, BA, and SE report no disclosures. BF is supported by grant funding from the DOD (JW200215 and W81XWH1920013). He received additional support for research through the NIH/NINDS, NIH/NIBIB, and NSF. He receives speaking fees and consulting fees from UCB Pharma, and serves on the scientific advisory boards of Marinus, Inc and Sage Therapeutics. NG reports no disclosures. EJG is supported by grant funding from the NIH R01NS117904-01, is a consultant for UCB and co-founder (no financial relationship) of Intracranial Bioanalytics (IBA). LJH has received consultation fees for advising from Accure, Aquestive, Ceribell, Eisai, Marinus, Medtronic, Neurelis, Neuropace and UCB; royalties from Wolters-Kluwer for authoring chapters for UpToDate-Neurology, and from Wiley for co-authoring the book "Atlas of EEG in Critical Care"; and honoraria for speaking or running webinars from Neuropace, Natus, and UCB. PK reports no disclosures. VL reports no disclosures. JK is supported by grant funding through the University of Calgary, Office of Health and Medical Education Scholarship. PV is supported by grants from NIH and the State of California PV has received compensation for consultancy and speaker fees and expenses from Ceribell and consultancy and speaker fees from UCB Pharma. SFZ is supported by grant funding from the NIH K23NS114201 and the American Epilepsy Society (Infrastructure grant). She is a clinical neurophysiologist for Corticare. BR reports no disclosures. JC is a minority shareholder at iCE Neurosystems. EDAT- 2022/08/24 06:00 MHDA- 2022/09/15 06:00 PMCR- 2023/10/01 CRDT- 2022/08/23 11:23 PHST- 2022/04/30 00:00 [received] PHST- 2022/07/31 00:00 [accepted] PHST- 2022/08/24 06:00 [pubmed] PHST- 2022/09/15 06:00 [medline] PHST- 2022/08/23 11:23 [entrez] PHST- 2023/10/01 00:00 [pmc-release] AID - 10.1007/s00134-022-06854-3 [pii] AID - 10.1007/s00134-022-06854-3 [doi] PST - ppublish SO - Intensive Care Med. 2022 Oct;48(10):1443-1462. doi: 10.1007/s00134-022-06854-3. Epub 2022 Aug 23.