Automated Pupillometry for Prediction of Electroencephalographic Reactivity in Critically Ill Patients: A Prospective Cohort Study.
EEG
autonomic dysfunction
brain injury
encephalopathy
intensive care unit
pupillary function
Journal
Frontiers in neurology
ISSN: 1664-2295
Titre abrégé: Front Neurol
Pays: Switzerland
ID NLM: 101546899
Informations de publication
Date de publication:
2022
2022
Historique:
received:
01
02
2022
accepted:
28
02
2022
entrez:
7
4
2022
pubmed:
8
4
2022
medline:
8
4
2022
Statut:
epublish
Résumé
Electroencephalography (EEG) is widely used to monitor critically ill patients. However, EEG interpretation requires the presence of an experienced neurophysiologist and is time-consuming. Aim of this study was to evaluate whether parameters derived from an automated pupillometer (AP) might help to assess the degree of cerebral dysfunction in critically ill patients. Prospective study conducted in the Department of Intensive Care of Erasme University Hospital in Brussels, Belgium. Pupillary assessments were performed using the AP in three subgroups of patients, concomitantly monitored with continuous EEG: "anoxic brain injury", "Non-anoxic brain injury" and "other diseases". An independent neurologist blinded to patient's history and AP results scored the degree of encephalopathy and reactivity on EEG using a standardized scale. The mean value of Neurologic Pupil Index (NPi), pupillary size, constriction rate, constriction and dilation velocity (CV and DV) and latency for both eyes, obtained using the NPi®-200 (Neuroptics, Laguna Hills, CA, USA), were reported. We included 214 patients (mean age 60 years, 55% male). EEG tracings were categorized as: mild ( This study suggests that low DV measured by the AP might effectively identify an unreactive EEG background, in particular in critically ill patients without anoxic brain injury.
Sections du résumé
Background
UNASSIGNED
Electroencephalography (EEG) is widely used to monitor critically ill patients. However, EEG interpretation requires the presence of an experienced neurophysiologist and is time-consuming. Aim of this study was to evaluate whether parameters derived from an automated pupillometer (AP) might help to assess the degree of cerebral dysfunction in critically ill patients.
Methods
UNASSIGNED
Prospective study conducted in the Department of Intensive Care of Erasme University Hospital in Brussels, Belgium. Pupillary assessments were performed using the AP in three subgroups of patients, concomitantly monitored with continuous EEG: "anoxic brain injury", "Non-anoxic brain injury" and "other diseases". An independent neurologist blinded to patient's history and AP results scored the degree of encephalopathy and reactivity on EEG using a standardized scale. The mean value of Neurologic Pupil Index (NPi), pupillary size, constriction rate, constriction and dilation velocity (CV and DV) and latency for both eyes, obtained using the NPi®-200 (Neuroptics, Laguna Hills, CA, USA), were reported.
Results
UNASSIGNED
We included 214 patients (mean age 60 years, 55% male). EEG tracings were categorized as: mild (
Conclusions
UNASSIGNED
This study suggests that low DV measured by the AP might effectively identify an unreactive EEG background, in particular in critically ill patients without anoxic brain injury.
Identifiants
pubmed: 35386412
doi: 10.3389/fneur.2022.867603
pmc: PMC8977520
doi:
Types de publication
Journal Article
Langues
eng
Pagination
867603Informations de copyright
Copyright © 2022 Peluso, Ferlini, Talamonti, Ndieugnou Djangang, Gouvea Bogossian, Menozzi, Annoni, Macchini, Legros, Severgnini, Creteur, Oddo, Vincent, Gaspard and Taccone.
Déclaration de conflit d'intérêts
FT and MO are scientific advisors for NeurOptics Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Curr Neurol Neurosci Rep. 2019 Aug 23;19(10):71
pubmed: 31440851
Acta Neurol Scand. 2020 Aug;142(2):181-185
pubmed: 32392619
J Clin Neurophysiol. 2013 Feb;30(1):1-27
pubmed: 23377439
Indian J Pediatr. 1985 Nov-Dec;52(419):625-31
pubmed: 3836969
Crit Care. 2006;10(6):R154
pubmed: 17083735
Neurol Clin. 2008 May;26(2):487-506, ix
pubmed: 18514823
Clin Neurophysiol. 2019 Aug;130(8):1263-1270
pubmed: 31163372
J Crit Care. 2021 Apr;62:176-182
pubmed: 33388562
J Neurosci Nurs. 2018 Aug;50(4):220-224
pubmed: 29985274
Intensive Care Med. 2018 Dec;44(12):2102-2111
pubmed: 30478620
Curr Neuropharmacol. 2008 Sep;6(3):254-85
pubmed: 19506724
Neurology. 2012 Mar 13;78(11):796-802
pubmed: 22323758
Brain Sci. 2021 Jul 01;11(7):
pubmed: 34356123
Resuscitation. 2019 Sep;142:168-174
pubmed: 31211949
Intensive Care Med. 2014 Apr;40(4):484-95
pubmed: 24522878
J Intensive Care Med. 2021 Apr;36(4):383-391
pubmed: 31601157
J Clin Neurosci. 2016 Nov;33:79-82
pubmed: 27422586
Crit Care. 2020 Mar 24;24(1):100
pubmed: 32204723
Chest. 2020 May;157(5):1167-1174
pubmed: 31870911
Neuron. 2016 Jan 6;89(1):221-34
pubmed: 26711118
Neurology. 2011 Aug 16;77(7):623-30
pubmed: 21775743
J Neurosurg Anesthesiol. 2021 Apr 1;33(2):161-166
pubmed: 31343506
Intensive Care Med. 2015 Apr;41(4):686-94
pubmed: 25763756
Crit Care Nurs Clin North Am. 2016 Mar;28(1):101-7
pubmed: 26873763
J Clin Neurophysiol. 2016 Jun;33(3):211-6
pubmed: 27258444