2022
Electroencephalogram in the intensive care unit: a focused look at acute brain injury
Alkhachroum A, Appavu B, Egawa S, Foreman B, Gaspard N, Gilmore EJ, Hirsch LJ, Kurtz P, Lambrecq V, Kromm J, Vespa P, Zafar SF, Rohaut B, Claassen J. Electroencephalogram in the intensive care unit: a focused look at acute brain injury. Intensive Care Medicine 2022, 48: 1443-1462. PMID: 35997792, PMCID: PMC10008537, DOI: 10.1007/s00134-022-06854-3.Peer-Reviewed Original ResearchMeSH KeywordsBrain InjuriesElectroencephalographyHumansIntensive Care UnitsSeizuresStatus EpilepticusConceptsAcute brain injuryNonconvulsive status epilepticusBrain injuryStatus epilepticusEEG monitoringIntensive care unit settingRefractory status epilepticusSecondary brain injuryIntensive care unitPossible clinical relevanceAssessment of consciousnessResource-limited settingsICU EEG monitoringFrequent seizuresAcute illnessCommon indicationCare unitWorse outcomesUnit settingClinical relevancePathophysiological eventsSeizure criteriaIschemia monitoringInjuryApplication of electroencephalography
2020
Evaluating the Clinical Impact of Rapid Response Electroencephalography: The DECIDE Multicenter Prospective Observational Clinical Study.
Vespa PM, Olson DM, John S, Hobbs KS, Gururangan K, Nie K, Desai MJ, Markert M, Parvizi J, Bleck TP, Hirsch LJ, Westover MB. Evaluating the Clinical Impact of Rapid Response Electroencephalography: The DECIDE Multicenter Prospective Observational Clinical Study. Critical Care Medicine 2020, 48: 1249-1257. PMID: 32618687, PMCID: PMC7735649, DOI: 10.1097/ccm.0000000000004428.Peer-Reviewed Original ResearchConceptsNonconvulsive seizuresSeizure diagnosisTreatment planProspective observational clinical studyDiagnostic assessmentObservational clinical studyAssessment of patientsCritical care settingSerious adverse effectsTherapeutic decision makingProspective multicenterSecondary outcomesICU patientsPrimary outcomeStatus epilepticusHigh suspicionElectroencephalography assessmentAcademic hospitalBedside assessmentClinical impactClinical studiesObservational studyCare settingsPhysician confidencePatients
2019
Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy.
Ghassemi MM, Amorim E, Alhanai T, Lee JW, Herman ST, Sivaraju A, Gaspard N, Hirsch LJ, Scirica BM, Biswal S, Moura Junior V, Cash SS, Brown EN, Mark RG, Westover MB. Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy. Critical Care Medicine 2019, 47: 1416-1423. PMID: 31241498, PMCID: PMC6746597, DOI: 10.1097/ccm.0000000000003840.Peer-Reviewed Original ResearchConceptsHypoxic-ischemic encephalopathyNeurologic outcomeElectroencephalogram featuresAcute hypoxic-ischemic encephalopathyAcademic medical centerBetter prognostic predictionReceiver operator curveNeurologic recoveryComatose patientsPrognostic implicationsCardiac arrestMedical CenterPrognostication performancePrognostic predictionOperator curveLogistic regressionSequential logistic regressionSpecificity thresholdEncephalopathyStatistical associationOutcomes
2016
Sensitivity of quantitative EEG for seizure identification in the intensive care unit
Haider HA, Esteller R, Hahn CD, Westover MB, Halford JJ, Lee JW, Shafi MM, Gaspard N, Herman ST, Gerard EE, Hirsch LJ, Ehrenberg JA, LaRoche SM, Abend N, Nwankwo C, Politsky J, Herman S, Loddenkemper T, Huh L, Carpenter J, Hantus S, Claassen J, Husain A, Gaspard N, Gloss D, Ritzl E, Gofton T, Goldstein J, Hocker S, Hyslop A, Williams K, Bozarth X, Wusthoff C, Fernandez A, Szaflarski J, Kramer A, Foreman B, Korb P, Rudzinski L, Sainju R, Hopp J, Mani R, Davis K, Kalamangalam G, Ding K, Quigg M, Haas K, Ostendorf A, Zutshi D, Pargeon K. Sensitivity of quantitative EEG for seizure identification in the intensive care unit. Neurology 2016, 87: 935-944. PMID: 27466474, PMCID: PMC5035158, DOI: 10.1212/wnl.0000000000003034.Peer-Reviewed Original Research
2015
Quantification of EEG reactivity in comatose patients
Hermans MC, Westover MB, van Putten MJ, Hirsch LJ, Gaspard N. Quantification of EEG reactivity in comatose patients. Clinical Neurophysiology 2015, 127: 571-580. PMID: 26183757, PMCID: PMC4885124, DOI: 10.1016/j.clinph.2015.06.024.Peer-Reviewed Original ResearchConceptsComatose patientsAcute brain failure in severe sepsis: a prospective study in the medical intensive care unit utilizing continuous EEG monitoring
Gilmore EJ, Gaspard N, Choi HA, Cohen E, Burkart KM, Chong DH, Claassen J, Hirsch LJ. Acute brain failure in severe sepsis: a prospective study in the medical intensive care unit utilizing continuous EEG monitoring. Intensive Care Medicine 2015, 41: 686-694. PMID: 25763756, DOI: 10.1007/s00134-015-3709-1.Peer-Reviewed Original ResearchMeSH KeywordsAgedAPACHEElectroencephalographyFemaleHumansIntensive Care UnitsMaleMiddle AgedPrevalenceProspective StudiesSeizuresSepsisStatus EpilepticusConceptsNonconvulsive seizuresSevere sepsisEEG reactivityPeriodic dischargesLate seizuresSOFA scoreAPACHE IIFunctional outcomeContinuous sedationHigh riskLower riskMedical intensive care unitLong-term cognitive outcomesPresence of sedationAPACHE II scoreGood functional outcomeNonconvulsive status epilepticusIntensive care unitContinuous EEG monitoringAcute brain failureAcademic medical centerNew epilepsyII scoreClinical seizuresMedical ICU
2013
Continuous electroencephalography in a surgical intensive care unit
Kurtz P, Gaspard N, Wahl AS, Bauer RM, Hirsch LJ, Wunsch H, Claassen J. Continuous electroencephalography in a surgical intensive care unit. Intensive Care Medicine 2013, 40: 228-234. PMID: 24240843, DOI: 10.1007/s00134-013-3149-8.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusPeriodic epileptiform dischargesNonconvulsive seizuresPoor outcomeClinical seizuresSICU patientsRetrospective studyCEEG monitoringMental statusSurgical intensive care unit patientsIntensive care unit patientsSurgical intensive care unitCare unit patientsContinuous electroencephalography monitoringMajority of patientsIntensive care unitMultivariable logistic regressionLiver transplantationHospital dischargeUnit patientsAbdominal surgeryPrimary outcomeStatus epilepticusCare unitMean ageSimilarity of Lateralized Rhythmic Delta Activity to Periodic Lateralized Epileptiform Discharges in Critically Ill Patients
Gaspard N, Manganas L, Rampal N, Petroff OA, Hirsch LJ. Similarity of Lateralized Rhythmic Delta Activity to Periodic Lateralized Epileptiform Discharges in Critically Ill Patients. JAMA Neurology 2013, 70: 1288-1295. PMID: 23921464, DOI: 10.1001/jamaneurol.2013.3475.Peer-Reviewed Original ResearchConceptsLateralized rhythmic delta activityRhythmic delta activityContinuous EEG monitoringIll patientsDelta activityPeriodic dischargesAcute seizuresClinical significanceIll subjectsEEG monitoringEEG patternsPeriodic lateralized epileptiform dischargesJuxtacortical white matterContinuous electroencephalography monitoringIntensive care unitCross-sectional prevalenceFocal EEG abnormalitiesAcademic medical centerSimilar clinical significanceRadiological correlatesEarly seizuresMost patientsAcute illnessDischarge groupIndependent predictorsIntravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study
Gaspard N, Foreman B, Judd LM, Brenton JN, Nathan BR, McCoy BM, Al‐Otaibi A, Kilbride R, Fernández IS, Mendoza L, Samuel S, Zakaria A, Kalamangalam GP, Legros B, Szaflarski JP, Loddenkemper T, Hahn CD, Goodkin HP, Claassen J, Hirsch LJ, LaRoche SM. Intravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study. Epilepsia 2013, 54: 1498-1503. PMID: 23758557, PMCID: PMC3731413, DOI: 10.1111/epi.12247.Peer-Reviewed Original ResearchConceptsRefractory status epilepticusTreatment of RSEIntravenous ketamineStatus epilepticusBrain injuryEpisodes of RSEPostanoxic brain injuryAnoxic brain injuryMulticenter retrospective reviewRetrospective multicenter studyRole of ketaminePossible adverse eventsAcademic medical centerKetamine initiationProspective trialAdverse eventsRetrospective reviewRetrospective seriesSE onsetMulticenter studyLast drugMedical recordsMedical CenterSafe drugConcurrent drugs
2012
Interrater Reliability of ICU EEG Research Terminology
Mani R, Arif H, Hirsch LJ, Gerard EE, LaRoche SM. Interrater Reliability of ICU EEG Research Terminology. Journal Of Clinical Neurophysiology 2012, 29: 203-212. PMID: 22659712, DOI: 10.1097/wnp.0b013e3182570f83.Peer-Reviewed Original Research
2010
Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices
Stuart RM, Schmidt M, Kurtz P, Waziri A, Helbok R, Mayer SA, Lee K, Badjatia N, Hirsch LJ, Connolly ES, Claassen J. Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices. Neurocritical Care 2010, 12: 188-198. PMID: 20107926, DOI: 10.1007/s12028-010-9330-9.Peer-Reviewed Original ResearchConceptsAcute brain injuryBrain injurySevere acute brain injuryNeurological intensive care unitInsertion techniqueSecondary brain injuryDay of admissionMethodsSixty-one patientsRate of hematomaSingle-institution reviewIntensive care unitBrain tissue oxygenCerebral blood flowFocal brain injuryMultimodality brain monitoringPatient-specific selectionInvasive monitoring devicesHospital lengthFrequent complicationNICU lengthPatient demographicsCare unitMultimodality monitoringConsecutive seriesInstitution review
2009
Intracortical electroencephalography in acute brain injury
Waziri A, Claassen J, Stuart RM, Arif H, Schmidt JM, Mayer SA, Badjatia N, Kull LL, Connolly ES, Emerson RG, Hirsch LJ. Intracortical electroencephalography in acute brain injury. Annals Of Neurology 2009, 66: 366-377. PMID: 19798724, DOI: 10.1002/ana.21721.Peer-Reviewed Original ResearchConceptsSecondary neurological complicationsElectrographic seizuresIctal activityNeurological complicationsScalp electroencephalographyNeurological injuryBrain injuryIntracortical EEGIntensive care unit settingSecondary neurological injurySecondary neuronal injuryAcute brain injuryIll neurological patientsIntracortical electroencephalographyClinical deteriorationNeuronal injuryInvasive neuromonitoringUnderwent implantationNeuromonitoring modalitiesBedside placementIctal dischargesRhythmic deltaUnit settingAcute changesContinuous electroencephalographyContinuous Electroencephalogram Monitoring in the Intensive Care Unit
Friedman D, Claassen J, Hirsch LJ. Continuous Electroencephalogram Monitoring in the Intensive Care Unit. Anesthesia & Analgesia 2009, 109: 506-523. PMID: 19608827, DOI: 10.1213/ane.0b013e3181a9d8b5.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringNonconvulsive seizuresIll patientsIntracranial pressureBrain functionContinuous electroencephalogram monitoringConvulsive status epilepticusIntensive care unitMajority of seizuresMultimodality brain monitoringPharmacological comaNeurologic outcomeNeurologic statusNeuronal injuryBrain ischemiaStatus epilepticusCare unitSecondary injurySubarachnoid hemorrhageCEEG monitoringClinical examinationElectroencephalogram monitoringSystemic abnormalitiesIntracranial EEG recordingsHigh riskContinuous electroencephalography in the medical intensive care unit*
Oddo M, Carrera E, Claassen J, Mayer SA, Hirsch LJ. Continuous electroencephalography in the medical intensive care unit*. Critical Care Medicine 2009, 37: 2051-2056. PMID: 19384197, DOI: 10.1097/ccm.0b013e3181a00604.Peer-Reviewed Original ResearchMeSH KeywordsAgedBrain DiseasesElectroencephalographyFemaleHumansIntensive Care UnitsMaleMiddle AgedPrognosisRetrospective StudiesSeizuresSepsisConceptsContinuous electroencephalography monitoringPeriodic epileptiform dischargesMajority of patientsElectrographic seizuresRetrospective studyMedical intensive care unit patientsIntensive care unit admissionMedical intensive care unitIntensive care unit patientsPeriodic dischargesAcute neurologic conditionsPrimary admission diagnosisCare unit admissionPercent of patientsAcute neurologic injuryCare unit patientsIntensive care unitOnly significant predictorUnit admissionAdmission diagnosisICU admissionMICU patientsHospital dischargeNeurologic injurySeptic patients
2005
Continuous electroencephalogram monitoring in critically ill patients
Jette N, Hirsch LJ. Continuous electroencephalogram monitoring in critically ill patients. Current Neurology And Neuroscience Reports 2005, 5: 312-321. PMID: 15987616, DOI: 10.1007/s11910-005-0077-1.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringIll patientsPermanent neuronal injuryContinuous electroencephalogram monitoringStandard of careRhythmic EEG patternsNeuronal injuryCerebral ischemiaNonconvulsive seizuresNeurologic impairmentClinical managementContinuous brain monitoringElectroencephalogram monitoringEEG monitoringPatientsEEG patternsBrain monitoringFurther studiesSeizuresIndicationsRemarkable advancesIschemiaInjuryPrognosticationImpairment
2004
Brain monitoring: the next frontier of ICU monitoring.
Hirsch LJ. Brain monitoring: the next frontier of ICU monitoring. Journal Of Clinical Neurophysiology 2004, 21: 305-6. PMID: 15592004.Peer-Reviewed Original ResearchContinuous EEG Monitoring in the Intensive Care Unit: An Overview
Hirsch LJ. Continuous EEG Monitoring in the Intensive Care Unit: An Overview. Journal Of Clinical Neurophysiology 2004, 21: 332-340. PMID: 15592007, DOI: 10.1097/01.wnp.0000147129.80917.0e.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaBrain MappingCritical CareElectroencephalographyEpilepsy, GeneralizedHumansIntensive Care UnitsPrognosisSeizuresUnited StatesConceptsPeriodic epileptiform dischargesComatose patientsEpileptiform dischargesEEG patternsIntensive care unitLevel of sedationContinuous EEG monitoringMajority of seizuresHospital infarctionNoncomatose patientsRecent neurosurgeryClinical seizuresCNS infectionICU patientsIll patientsNonconvulsive seizuresCare unitWorse outcomesAutonomic changesParoxysmal spellsBrain tumorsPatientsEEG monitoringEEG trendsSeizures