Electroencephalography in delirium assessment: a scoping review
Tim L T Wiegand1,2, Jan Rémi2, Konstantinos Dimitriadis3,4
1cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.
BMC Neurology
|March 12, 2022
Summary
Electroencephalography (EEG) shows promise for diagnosing delirium in intensive care units (ICUs), with all reviewed studies noting EEG alterations. However, varied research protocols prevent standardized recommendations for this common ICU disorder.
Area of Science:
- Neuroscience
- Critical Care Medicine
Background:
- Delirium affects approximately 31% of intensive care unit (ICU) patients.
- Current delirium assessment tools are time-consuming, lack specificity for etiology, and may have low clinical sensitivity.
- Electroencephalography (EEG) is increasingly used in ICUs, but lacks standardized interpretation criteria for delirium.
Purpose of the Study:
- To conduct a scoping review of electroencephalography (EEG) findings in patients with delirium.
- To synthesize current evidence on EEG's utility in diagnosing and understanding delirium in the ICU setting.
Main Methods:
- A comprehensive scoping review of 1,236 articles identified via PubMed and Embase.
- Inclusion of 33 original research articles for qualitative synthesis of EEG findings in delirium.
Main Results:
- All 33 included studies reported qualitative or quantitative EEG alterations in patients with delirium.
- Normal routine EEG (rEEG) and continuous EEG (cEEG) findings make delirium unlikely.
- Significant heterogeneity in study protocols (timing, duration, methods, patient populations, delirium diagnostics) precludes quantitative synthesis and common recommendations.
Conclusions:
- Further research is needed to standardize EEG recording and evaluation methods for clinical delirium detection.
- Growing evidence supports quantitative EEG markers, such as increased relative delta power and decreased beta power, for delirium detection.
- Longitudinal EEG studies correlating delirium evolution with patient outcomes are essential.
