Autoren:	Tschernatsch, Marlene Juenemann, Martin Alhaidar, Fouad El Shazly, Jasmin Butz, Marius Meyer, Marco Gerriets, Tibo Schönburg, Markus Schramm, Patrick
Titel:	Epileptic seizure discharges in patients after open chamber cardiac surgery : a prospective prevalence pilot study using continuous electroencephalography
Online-Publikationsdatum:	6-Mai-2021
Erscheinungsdatum:	2020
Sprache des Dokuments:	Englisch
Zusammenfassung/Abstract:	PURPOSE Patients undergoing cardiac surgery often develop delirium which increases the risk of postoperative morbidity and leads to a reduced quality of life. Retrospective studies show a higher incidence of delirium in patients with seizures. However, these studies do not systematically detect subclinical seizures, so the incidence of seizures after cardiac surgery remains speculative. The objective of this study is to determine the prevalence of electrographic seizures after elective open-chamber cardiac surgery. METHODS This prospective, blinded, monocentric, observational study investigated patients scheduled for elective open-chamber valve reconstruction or replacement. Anaesthesia, surgery and postoperative treatment were standardized and not influenced by the presented observation. After surgery, all patients arrived at the ICU, and EEG monitoring started within the first hour. EEG recording was continuously performed for up to 24 h, and the results were independently analysed by two blinded EEG board-certified neurologists. RESULTS 100 patients were included. Abnormal EEG patterns were present in 33% of patients, and 9% of all patients showed electrographic seizures. The main EEG activity at the beginning of each recording was suppressed or showed a burst-suppression pattern, and at the end of recording, all patients had an alpha/theta rhythm. An association between electrographic seizures and delirium was found (pχ2 < 0.01). CONCLUSION This study reveals a surprisingly high incidence of abnormal EEG patterns and electrographic seizures in patients undergoing open-chamber cardiac surgery. As electrographic seizures are associated with the incidence of delirium, this finding is a relevant phenomenon in the post-cardiac surgery ICU population.
DDC-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-5764
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY-NC
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by-nc/4.0/
Zeitschrift:	Intensive care medicine 46
Seitenzahl oder Artikelnummer:	1418 1424
Verlag:	Springer
Verlagsort:	Berlin u.a.
Erscheinungsdatum:	2020
ISSN:	1432-1238
URL der Originalveröffentlichung:	https://doi.org/10.1007/s00134-020-06073-8
DOI der Originalveröffentlichung:	10.1007/s00134-020-06073-8
Enthalten in den Sammlungen:	JGU-Publikationen