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DOI: 10.1016/j.medine.2019.06.008
Available online 25 June 2019
Electroencephalographic monitoring in the critically ill patient: What useful information can it contribute?
Monitorización electroencefalográfica en el paciente crítico: ¿qué información útil puede aportar?
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C. Rubiñosa,
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car2252@cumc.columbia.edu

Corresponding author.
, D.A. Godoyb,c
a Department of Neurology, Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
b Neurointensive Care Unit, Sanatorio Pasteur, Catamarca, Argentina
c Intensive Care Unit, Hospital San Juan Bautista, Catamarca, Argentina
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Received 17 December 2018. Accepted 08 March 2019
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Abstract

Monitoring is a crucial part of the care of the critically ill patient. It detects organ dysfunction and provides guidance on the therapeutic approach. Intensivists closely monitor the function of various organ systems, and the brain is no exception. Continuous EEG monitoring is a noninvasive and uninterrupted way of assessing cerebral cortical activity with good spatial and excellent temporal resolution. The diagnostic effectiveness of non-convulsive status epilepticus as a cause of unexplained consciousness disorder has increased the use of continuous EEG monitoring in the neurocritical care setting. However, non-convulsive status epilepticus is not the only indication for the assessment of cerebral cortical activity. This study summarizes the indications, usage and methodology of continuous EEG monitoring in the intensive care unit, with the aim of allowing practitioners to become familiarized the technique.

Keywords:
Electroencephalography
Seizures
Monitoring
Critically ill
Prognosis
Acute confusional syndrome
Non-convulsive status epilepticus
Resumen

La monitorización es crucial en el cuidado del paciente crítico. Detecta disfunciones orgánicas y provee orientación en el abordaje terapéutico. Los intensivistas monitorizan habitualmente la función de varios sistemas orgánicos y el cerebro no es la excepción. La monitorización EEG continuo es una vía no invasiva e ininterrumpida para valorar la actividad eléctrica cortical con aceptable resolución espacial y excelente resolución temporal. La efectividad diagnóstica del estado epiléptico no convulsivo como causa de compromiso de la consciencia no explicable por otras causas se ha incrementado con el empleo del EEG continuo; sin embargo, no es la única indicación para valorar la actividad eléctrica cortical cerebral. Este manuscrito intenta resumir las indicaciones, modos de empleo y metodología para el empleo del monitoreo electroencefalográfico continuo en la unidad de cuidados intensivos con la finalidad que el intensivista se familiarice con el mismo.

Palabras clave:
Electroencefalografía
Convulsiones
Monitoreo
Paciente critico
Pronostico
Síndrome confusional agudo
Estado no convulsivo

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