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Long-term EEG compression for intensive-care settings.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Agarwal, Rajeev Gotman, Jean |
| Copyright Year | 2001 |
| Abstract | Every year thousands of patients are admitted to neurological intensive care units (NICUs) with brain function that may be in jeopardy. Due to the simplicity and ease of administration, the most popular modality of monitoring central nervous system (CNS) function is the serial neurological examination, more commonly known as a series of “neurochecks.” Such clinical examinations, even when performed with extreme diligence, are discontinuous and subject to the physician’s experience and expertise [1]. The results of such exams do not provide the overall state of the CNS since the function of many brain regions cannot be tested with such a simple test. Moreover, serial neurological examinations rely on behavioral manifestation of CNS deterioration, which may be too late in providing adequate therapeutic management. There is clearly a need to improve and objectify methods of assessing the state of brain function [2, 3]. Neurophysiologic techniques such as electroencephalography are becoming increasingly important in providing better patient care in the NICUs. As with other modalities of monitoring in the ICU (e.g., EKG), the first goal of NICU electroencephalogram (EEG) monitoring is to detect the onset of abnormalities at a reversible stage. A second but important role is to know the effect of treatment on the brain. It is important to know when treatment is effective and must be pursued or when it is ineffective and should be discontinued. Often, the EEG can provide significant information about brain function prior to clinical manifestationa window of opportunity for appropriate interventions [3]. There is considerable evidence that continuous EEG can play a vital role in patient management (for example, in the detection of cerebral ischemia prior to irreversible brain tissue injury) [2]. That is, the EEG becomes substantially suppressed with decline in cerebral blood flow ranging from 2 to 30 ml/100g/min [4]; however, irreversible damage occurs at flows of 10-12 ml/100g/min. Examples of other areas in which continuous EEG can play a valuable role include coma (diagnosis and prognosis) [5], the detection of subclinical epileptic seizures [8], the monitoring of postcardiac surgery patients [6], hypoxia [7], metabolic encephalopathies [7], severe head-trauma injuries, and poststatus epilepticus treatment monitoring [8]. Continuous EEG is also useful in the classification of sleep stage cycling [9, 10]. Given its various advantages, it is believed that EEG can play a vital role in providing a sensitive indication of cerebral function during periods when the brain is at risk. These periods are often of long duration (several hours or days); hence, prolonged EEG recording is required. The amount of data generated is large and review/interpretation of the raw data is time-consuming. Unlike other modalities of monitoring, EEG interpretation requires considerable training and is usually restricted to personnel experienced and trained to read EEGs [11]. Clearly, specialists cannot be available for continuous monitoring. Moreover, personnel cannot keep continuous vigil over the EEG, thus the detection of onset of abnormalities or the classification of EEGs is best performed by automatic computer methods. Among other problems, the difficulty in reviewing and interpreting the raw data has been primarily responsible for the limited use of EEG in the ICU or postoperative recovery monitoring. In order for continuous EEG monitoring to become prevalent in the ICU, there is a need for quantitative EEG that can serve as an aid for interpretation. The quantitative EEG can serve as a first pass |
| Starting Page | 467 |
| Ending Page | 475 |
| Page Count | 9 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://tcts.fpms.ac.be/biomed/private/papers/agarwal01_3.pdf |
| PubMed reference number | 11668893v1 |
| Volume Number | 20 |
| Issue Number | 5 |
| Journal | IEEE engineering in medicine and biology magazine : the quarterly magazine of the Engineering in Medicine & Biology Society |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Brain Diseases, Metabolic Brain Injuries CNS disorder Cerebral Ischemia Cerebrovascular Circulation Comatose Compression Congenital Abnormality Craniocerebral Trauma Electroencephalography Phase Synchronization Encephalopathies Epilepsy Flow Hypoxia Intensive Care Units, Neonatal Patients Review [Publication Type] Seizures Sleep Stages Status Epilepticus central nervous system tumor, pediatric intensive care unit nervous system disorder |
| Content Type | Text |
| Resource Type | Article |
