Early Clinical and Electrophysiological Brain Dysfunction Is Associated With ICU Outcomes in COVID-19 Critically Ill Patients With Acute Respiratory Distress Syndrome: A Prospective Bicentric Observational Study*

医学 谵妄 彗差(光学) 四分位间距 急性呼吸窘迫综合征 麻醉 镇静 观察研究 重症监护室 中止 前瞻性队列研究 重症监护 脑电图 突发抑制 儿科 内科学 重症监护医学 精神科 物理 光学
作者
Sarah Benghanem,Alain Cariou,Jean‐Luc Diehl,Angela Marchi,Julien Charpentier,Jean Loup Augy,Caroline Hauw‐Berlemont,Martine Gavaret,Frédéric Pène,Jean‐Paul Mira,Tarek Sharshar,Bertrand Hermann
出处
期刊:Critical Care Medicine [Lippincott Williams & Wilkins]
卷期号:50 (7): 1103-1115 被引量:4
标识
DOI:10.1097/ccm.0000000000005491
摘要

Describe the prevalence of acute cerebral dysfunction and assess the prognostic value of an early clinical and electroencephalography (EEG) assessment in ICU COVID-19 patients.Prospective observational study.Two tertiary critical care units in Paris, France, between April and December 2020.Adult critically ill patients with COVID-19 acute respiratory distress syndrome.Neurologic examination and EEG at two time points during the ICU stay, first under sedation and second 4-7 days after sedation discontinuation.Association of EEG abnormalities (background reactivity, continuity, dominant frequency, and presence of paroxystic discharges) with day-28 mortality and neurologic outcomes (coma and delirium recovery). Fifty-two patients were included, mostly male (81%), median (interquartile range) age 68 years (56-74 yr). Delayed awakening was present in 68% of patients (median awakening time of 5 d [2-16 d]) and delirium in 74% of patients who awoke from coma (62% of mixed delirium, median duration of 5 d [3-8 d]). First, EEG background was slowed in the theta-delta range in 48 (93%) patients, discontinuous in 25 patients (48%), and nonreactive in 17 patients (33%). Bifrontal slow waves were observed in 17 patients (33%). Early nonreactive EEG was associated with lower day-28 ventilator-free days (0 vs 16; p = 0.025), coma-free days (6 vs 22; p = 0.006), delirium-free days (0 vs 17; p = 0.006), and higher mortality (41% vs 11%; p = 0.027), whereas discontinuous background was associated with lower ventilator-free days (0 vs 17; p = 0.010), coma-free days (1 vs 22; p < 0.001), delirium-free days (0 vs 17; p = 0.001), and higher mortality (40% vs 4%; p = 0.001), independently of sedation and analgesia.Clinical and neurophysiologic cerebral dysfunction is frequent in COVID-19 ARDS patients. Early severe EEG abnormalities with nonreactive and/or discontinuous background activity are associated with delayed awakening, delirium, and day-28 mortality.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
无限雨南完成签到 ,获得积分10
刚刚
LL完成签到,获得积分10
1秒前
八月宁静发布了新的文献求助10
1秒前
1秒前
2秒前
波鲁鲁爱喝酸奶完成签到 ,获得积分10
2秒前
3秒前
核桃应助钱浩然采纳,获得10
5秒前
5秒前
脑洞疼应助张张张哈哈哈采纳,获得10
5秒前
6秒前
颠覆乾坤发布了新的文献求助10
7秒前
小王加油啊啊啊完成签到 ,获得积分10
7秒前
虚幻沛文完成签到 ,获得积分10
8秒前
hua完成签到 ,获得积分10
8秒前
zyf发布了新的文献求助10
9秒前
Ray完成签到,获得积分10
10秒前
yukiseto完成签到 ,获得积分10
10秒前
caozhi完成签到,获得积分10
10秒前
有魅力的发卡完成签到,获得积分10
11秒前
包容的若风完成签到,获得积分10
11秒前
szxnb666完成签到,获得积分20
12秒前
开心薯片完成签到,获得积分10
12秒前
HHH完成签到,获得积分10
13秒前
黑黑黑完成签到,获得积分10
14秒前
Kelly1426完成签到,获得积分10
15秒前
海边的曼彻斯特完成签到 ,获得积分10
15秒前
turbohero完成签到,获得积分10
15秒前
量子星尘发布了新的文献求助10
16秒前
英俊的铭应助开心薯片采纳,获得10
16秒前
17秒前
八月宁静完成签到,获得积分10
18秒前
小曾完成签到,获得积分10
18秒前
zyf完成签到,获得积分10
19秒前
高山流水完成签到,获得积分10
19秒前
咎淇完成签到,获得积分10
19秒前
kilig完成签到 ,获得积分10
20秒前
顾矜应助烊烊采纳,获得10
20秒前
平平无奇打工人完成签到 ,获得积分10
23秒前
Young完成签到 ,获得积分10
24秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038235
求助须知:如何正确求助?哪些是违规求助? 3575992
关于积分的说明 11374009
捐赠科研通 3305760
什么是DOI,文献DOI怎么找? 1819276
邀请新用户注册赠送积分活动 892662
科研通“疑难数据库(出版商)”最低求助积分说明 815022