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Table 1 Summary of included studies

From: Clinical neurophysiological assessment of sepsis-associated brain dysfunction: a systematic review

 

Ref

Study design

Location (ICU patients,%)

Number

Inclusion criteria

Patients with sepsis/infections (number, %)

APACHE II score

Survival (number, %)

Patients on sedatives and/or opiates (number, %)

Topic

Time to EEG/EPs (days)

EEG/EPs as primary outcome?

Case-control study (patients with systemic infection versus controls)

 

16

P

Internal medicine (NA)

73

CAP

43 (59%)

13 ± 4

NA

NA

qEEG VEP

1

Y

Case series of patients with sepsis

 

21

P

Medical and surgical ICU (100%)

71

SS with brain dysfunctiona

71 (100%)

NA (SAPS II 49 (38 to 60))

48 (68%)

49 (69%)

EEG

NA

N

 

20

NA

ICU (100%)

30

SSa

30 (100%)

32 ± 6

NA

30 (100%)

EEG

4

N

 

17

P

Medical ICU (100%)

68

SS

68 (100%)

NA (APACHE III, 101 ± 26)

31 (46%)

33 (49%)

SSEP

1 to 2

Y

 

19

NA

ICU (100%)

14

Sepsis

14 (100%)

18.6 ± 6.0

8 (57%)

12 (85%)

qEEG

1 to 5

Y

 

18

P

ICU (100%)

69

Severe Infectionsb

69 (100%)

NA

46 (67%)

0

EEG

NA

Y

 

22

NA

ICU(100%)

6

Severe Infectionsb

6 (100%)

NA

1 (17%)

0

EEG AEP

1 to 11

N

 

23

NA

NA (NA)

14

Severe Infectionsb

14 (100%)

NA

14 (100%)

NA

EEG

NA

Y

Case series or case-control studies including patients with and without sepsis

 

32

R

Surgical ICU (100%)

154

Encephalopathy +/− seizuresa

100 (65%)

NA

73 (47%)

106 (70%)

cEEG

4 to 9

Y

 

28

R

Hospital (70%)

154

Encephalopathy

72 (47%)

NA

135 (88%)

20 (13%)

EEG

NA

Y

 

27

R

Hospital (81%)

105

Encephalopathy and TWs

62 (59%)

NA

84 (80%)

20 (19%)

EEG

NA

Y

 

24

R

Hospital (88%)

400

GPDs

144 (36%)

NA

249 (62%)

NA

cEEG

NA

Y

 

30

R

Medical ICU (100%)

201

Encephalopathy +/− seizures

120 (60%)

NA

NA

29 (14%)

cEEG

NA

Y

 

26

P

Adult ICU (100%)

125

Patients on MVa

78 (62%)

27.4 ± 8.2

93 (74%)

123 (98%)

qEEG (BIS)

NA

Y

 

29

P

Surgical ICU (100%)

54

Post-abdominal surgery

24 (44%)

NA (SAPS II, 34 (22 to 48))

NA

0

AEP

1

Y

 

31

P

Burns ICU (100%)

64

SIRS

44 (69%)

NA

NA

NA

EEG

NA

N

 

25

P

Medical ICU (100%)

103

MOF and Encephalopathy

74 (72%)

NA (APACHE III, 101 ± 24)

52 (50%)

60 (58%)

SSEP

1 to 2

Y

  1. aexcluded pre-existing neurological or psychiatric diseases; bexcluded infections of the central nervous system. AEP, auditory evoked potentials; APACHE, Acute Physiology and Chronic Health Evaluation; BIS, bispectral index; CAP, community-acquired pneumonia; cEEG, continuous EEG monitoring; CI, confidence interval; CNS, central nervous system; EEG, electroencephalogram; GPDs, general periodic discharges; ICU, intensive care unit; MOF, multiple organ failure; MV, mechanical ventilation; N, No; NA, not available; P, prospective; qEEG, quantitative electroencephalography; R, retrospective; SAPS, Simplified Acute Physiology Score; SE, status epilepticus; SIRS, systemic inflammatory response syndrome; SS, severe sepsis or septic shock; SSEP, somatosensory evoked potential; TWs, triphasic waves; WBC, white blood cell; VEP, visual evoked potentials; Y, Yes.