Processed EEG monitoring for anesthesia and intensive care practice
Processed EEG monitoring for anesthesia and intensive care practice
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DOI：
10.23736/s0375-9393.19.13478-5
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发表时间：
2019-11-01
影响因子：
3.2
通讯作者：
Ricci, Zaccaria
中科院分区：
文献类型：
--
作者：
Romagnoli, Stefano;Franchi, Federico;Ricci, Zaccaria
个体对镇静剂和催眠药的反应具有高度变异性，在手术妈妈麻醉期间和重症监护室镇静期间确定个性化剂量可能具有有益效果。虽然脑是一般静脉和吸入麻醉剂的主要靶点，但脑电图（EEG）并没有常规用于探索镇静和麻醉的脑反应，这可能是因为EEG描记阅读复杂，需要脑电图学家的技能。原始EEG迹线的自动处理算法（经处理的EEG，pEEG）提供了易于使用的指数，可用于优化麻醉管理。大量高质量的研究和国际科学协会的建议已经证实了麻醉（和镇静）水平不足或过深的有害后果。在这种情况下，手术室麻醉和重症监护室中由pEEG监测器驱动的中度/深度镇静可能在不久的将来成为标准实践。本综述的目的是提供一个概述的现有知识和辩论的pEEG监测技术及其在麻醉和镇静的临床实践中的作用。
Individual response to sedatives and hypnotics is characterized by high variability and the identification of a personalized dose during anesthesia in the operating mom and during sedation in the intensive care unit may have beneficial effects. Although the brain is the main target of general intravenous and inhaled anesthetic agents, electroencephalography (EEG) is not routinely utilized to explore cerebral response to sedation and anesthesia probably because EEG trace reading is complex and requires encephalographers' skills. Automated processing algorithms (processed EEG, pEEG) of raw EEG traces provide easy-to-use indices that can be utilized to optimize anesthetic management. A large number of high-quality studies and the recommendations of international scientific societies have confirmed the deleterious consequences of inadequate or excessively deep anesthesia (and sedation) level. In this context, anesthesia in the operating rooms and moderate/deep sedation in intensive care units driven by pEEG monitors could become a standard practice in the near future. The aim of the present review was to provide an overview of current knowledge and debate on available technologies for pEEG monitoring and their role in clinical practice for anesthesia and sedation.