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Frontotemporal EEG to guide sedation in COVID-19 related acute respiratory distress syndrome.
Michalak, Andrew J; Mendiratta, Anil; Eliseyev, Andrey; Ramnath, Brian; Chung, Jane; Rasnow, Jarret; Reid, Lawrence; Salerno, Steven; García, Paul S; Agarwal, Sachin; Roh, David; Park, Soojin; Bazil, Carl; Claassen, Jan.
  • Michalak AJ; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Mendiratta A; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Eliseyev A; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Ramnath B; NewYork Presbyterian Hospital, New York, NY, USA.
  • Chung J; NewYork Presbyterian Hospital, New York, NY, USA.
  • Rasnow J; NewYork Presbyterian Hospital, New York, NY, USA.
  • Reid L; NewYork Presbyterian Hospital, New York, NY, USA.
  • Salerno S; NewYork Presbyterian Hospital, New York, NY, USA.
  • García PS; Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA.
  • Agarwal S; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Roh D; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Park S; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Bazil C; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
  • Claassen J; Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA. Electronic address: jc1439@columbia.edu.
Clin Neurophysiol ; 132(3): 730-736, 2021 03.
Article in English | MEDLINE | ID: covidwho-1039319
ABSTRACT

OBJECTIVE:

To study if limited frontotemporal electroencephalogram (EEG) can guide sedation changes in highly infectious novel coronavirus disease 2019 (COVID-19) patients receiving neuromuscular blocking agent.

METHODS:

98 days of continuous frontotemporal EEG from 11 consecutive patients was evaluated daily by an epileptologist to recommend reduction or maintenance of the sedative level. We evaluated the need to increase sedation in the 6 h following this recommendation. Post-hoc analysis of the quantitative EEG was correlated with the level of sedation using a machine learning algorithm.

RESULTS:

Eleven patients were studied for a total of ninety-eight sedation days. EEG was consistent with excessive sedation on 57 (58%) and adequate sedation on 41 days (42%). Recommendations were followed by the team on 59% (N = 58; 19 to reduce and 39 to keep the sedation level). In the 6 h following reduction in sedation, increases of sedation were needed in 7 (12%). Automatized classification of EEG sedation levels reached 80% (±17%) accuracy.

CONCLUSIONS:

Visual inspection of a limited EEG helped sedation depth guidance. In a secondary analysis, our data supported that this determination may be automated using quantitative EEG analysis.

SIGNIFICANCE:

Our results support the use of frontotemporal EEG for guiding sedation in patients with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Temporal Lobe / Electroencephalography / Machine Learning / Frontal Lobe / COVID-19 Drug Treatment / Hypnotics and Sedatives Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Neurophysiol Journal subject: Neurology / Psychophysiology Year: 2021 Document Type: Article Affiliation country: J.clinph.2021.01.003

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Temporal Lobe / Electroencephalography / Machine Learning / Frontal Lobe / COVID-19 Drug Treatment / Hypnotics and Sedatives Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Clin Neurophysiol Journal subject: Neurology / Psychophysiology Year: 2021 Document Type: Article Affiliation country: J.clinph.2021.01.003