Blog Viewer

High Incidence of Epileptiform Activity in Adults Undergoing Extracorporeal Membrane Oxygenation

By Currents Editor posted 08-12-2022 09:29

  

Clinical Neurophysiology (05/06/22) DOI: 10.1016/j.clinph.2022.04.018
Amorim, Edilberto; Firme, Marcos S.; Zheng, Wei-Long; et al.
https://www.sciencedirect.com/science/article/abs/pii/S1388245722002619 

A recent study sought to estimate the prevalence of seizures and ictal-interictal continuum patterns in patients undergoing electroencephalography (EEG) during extracorporeal membrane oxygenation (ECMO). The retrospective review of a prospective ECMO registry from 2011-2018 included adult patients who had reduced level of consciousness and underwent EEG monitoring for seizure screening. Among 395 patients who had ECMO, 113 (28.6%) had EEG monitoring; 92 patients (23.3%) who had EEG performed during ECMO were included in the study. The most common cannulation method was veno-arterial ECMO, and 26 patients had extracorporeal cardiopulmonary resuscitation. The EEGs showed that nearly two-thirds of the patients (63%) had epileptiform activity or ictal-interictal continuum patterns. Nonconvulsive status epilepticus was uncommon, affecting 3%, while 36% had generalized periodic discharges and 5% had lateralized periodic discharges. In-hospital mortality and poor neurological outcome were comparable among patients with and without epileptiform activity. One-third of the patients had acute neuroimaging abnormalities. The findings show that epileptiform and ictal-interictal continuum abnormalities are often seen patients supported by ECMO and undergoing EEG monitoring, the study authors conclude.

#LiteratureWatch

FURTHER READING
Michelle Schober, MD, MS Audrey Paulson, DNP, FNP-BC, CCRN, CNRN, SCRN Ethical principles common to the various health care professions include the concepts of justice, nonmaleficence, beneficence, and autonomy. The American Nurses Association (ANA) Code contains these concepts and cites three additional ...
New England Journal of Medicine (10/20/22) DOI: 10.1056/NEJMoa2208687 Kjaergaard, Jesper; Møller, Jacob E.; Schmidt, Henrik; et al. https://www.nejm.org/doi/full/10.1056/NEJMoa2208687 For patients who had been resuscitated from cardiac arrest, targeting a mean arterial blood pressure of 77 mm Hg ...
By Sarah Livesay, DNP, APRN Associate Dean, Rush University, President NCS Mary Kay Bader, RN, MSN, Neurocritical Care CNS, Mission Hospital Mission Viejo CA, Past President NCS Karen Hirsch MD, Associate Professor of Neurology, Division Chief Neurocriticial Care, Stanford University Romer Geocadin ...