Herta J, Koren J, Fürbass F, Zöchmeister A, Hartmann M, Hosmann A, Baumgartner C, Gruber A. Applicability of NeuroTrend as a bedside monitor in the neuro ICU.
Clin Neurophysiol 2017;
128:1000-1007. [PMID:
28458027 DOI:
10.1016/j.clinph.2017.04.002]
[Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 03/21/2017] [Accepted: 04/02/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE
To assess whether ICU caregivers can correctly read and interpret continuous EEG (cEEG) data displayed with the computer algorithm NeuroTrend (NT) with the main attention on seizure detection and determination of sedation depth.
METHODS
120 screenshots of NT (480h of cEEG) were rated by 18 briefly trained nurses and biomedical analysts. Multirater agreements (MRA) as well as interrater agreements (IRA) compared to an expert opinion (EXO) were calculated for items such as pattern type, pattern location, interruption of recording, seizure suspicion, consistency of frequency, seizure tendency and level of sedation.
RESULTS
MRA as well as IRA were almost perfect (80-100%) for interruption of recording, spike-and-waves, rhythmic delta activity and burst suppression. A substantial agreement (60-80%) was found for electrographic seizure patterns, periodic discharges and seizure suspicion. Except for pattern localization (70.83-92.26%), items requiring a precondition and especially those who needed interpretation like consistency of frequency (47.47-79.15%) or level of sedation (41.10%) showed lower agreements.
CONCLUSIONS
The present study demonstrates that NT might be a useful bedside monitor in cases of subclinical seizures. Determination of correct sedation depth by ICU caregivers requires a more detailed training.
SIGNIFICANCE
Computer algorithms may reduce the workload of cEEG analysis in ICU patients.
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