Conductive Plastic Electrodes Reduce EEG Artifact During Pediatric ECMO Therapy.
Conductive Plastic Electrodes Reduce EEG Artifact During Pediatric ECMO Therapy.
复制标题
导电塑料电极可减少儿科 ECMO 治疗期间的脑电图伪影。
DOI：
10.1097/wnp.0000000000000262
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Sankar,Raman
中科院分区：
文献类型：
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作者：
Matsumoto,JoyceH;McArthur,DavidL;Szeliga,ConradW;Lerner,JasonT;Rao,LekhaM;Hussain,ShaunA;Wu,JoyceY;Nuwer,MarcR;Sankar,Raman
目的：体外膜肺氧合（ECMO）是一种挽救生命的心肺转流手术，但会引起大量的EEG伪影。尽管如此，连续EEG监测对于接受ECMO治疗的患者是一种有用的神经监测工具，因为神经系统并发症很常见，但镇静、神经肌肉阻滞和血流动力学不稳定等因素限制了临床和影像学评价。我们研究了是否使用导电塑料电极代替传统的金电极减少伪影在临床脑电图研究的儿科ECMO patients.Methods：四个蒙面脑电图评估伪影及其对整体脑电图解释的影响，从21个连续的脑电图记录在ECMO治疗（14金和7塑料）的样本。频谱功率分析，然后量化50- 70-Hz的伪影在一个更大的一组14个金电极和34个塑料电极的研究，在ECMO和4个non-ECMO gold electrode studies.Results：蒙面脑电图识别较少的伪影（P<0.001），并表示更大的信心与塑料电极记录的研究之间的EEG解释的准确性（P< 0.001）。在定量分析中，在使用金电极的研究中，ECMO与更大的50- 70-Hz功率相关（P< 0.001），金电极显示出比塑料电极更大的50- 70-Hz功率（P< 0.001）。对比大多数脑电图学家认为解释受到伪影影响（n= 12; 7个金色和5个塑料）或未受到伪影影响（n= 7;全金色）的研究，50至70 Hz功率在受损研究中同样更高（P< 0.001）。结论：塑料电极大大减少了对儿科ECMO患者进行的EEG研究中的电伪影负担，并提高了对EEG解释的信心。
Purpose:Extracorporeal membrane oxygenation (ECMO) is a life-saving heart and lung bypass procedure that can cause substantial EEG artifact. Continuous EEG monitoring is nonetheless a helpful neuromonitoring tool for patients receiving ECMO therapy because neurologic complications are frequent, but factors such as sedation, neuromuscular blockade, and hemodynamic instability limit clinical and radiographic evaluation. We examined whether using conductive plastic electrodes in place of conventional gold electrodes reduces artifact in clinical EEG studies of pediatric ECMO patients.Methods:Four masked electroencephalographers assessed artifact and its impact on overall EEG interpretation in samples from 21 consecutive EEGs recorded during ECMO therapy (14 gold and 7 plastic). A spectral power analysis then quantified 50-to 70-Hz artifact in a larger group of 14 gold and 34 plastic electrode studies during ECMO and 4 non-ECMO gold electrode studies.Results:The masked electroencephalographers identified less artifact (P< 0.001) and indicated greater confidence in the accuracy of EEG interpretation (P< 0.001) among studies recorded with plastic electrodes. In quantitative analyses, ECMO was associated with greater 50-to 70-Hz power among studies using gold electrodes (P< 0.001) and gold electrodes exhibited greater 50-to 70-Hz power than plastic electrodes (P< 0.001). Contrasting studies in which most of the electroencephalographers believed that interpretation was (n= 12; 7 gold and 5 plastic) or was not (n= 7; all gold) compromised by artifact, 50-to 70-Hz power was similarly higher among the compromised studies (P< 0.001).Conclusion:Plastic electrodes substantially reduce the burden of electrical artifact in EEG studies performed on pediatric ECMO patients and improve confidence in EEG interpretation.