Clinical Electroencephalography for Anesthesiologists and Intensivists: Part 2—Physiologic Signatures and Active Management
Christian S. Guay, Uday Agrawal, Bryan Tseng, Sebastian Gallo, David R. Schreier, Emery N. Brown
Abstract
The electroencephalogram (EEG) offers physicians a window into their patients' neurologic and broader physiologic states. Frontal EEG interpretation is emerging as a core competency for anesthesiologists and intensivists. Part 1 of this series reviewed the basics of frontal EEG, including relevant biophysics, neuroanatomy, and anesthetic-mediated frontal EEG signatures of sedation and unconsciousness. In part 2, the authors outline a set of physiologic signatures that integrate the basics of EEG interpretation presented in part 1 with the systemic pathophysiology commonly seen in critical illness. They organize these signatures into a systematic framework to facilitate use of frontal EEG monitoring in the active management of critically ill patients. Finally, the authors use case examples to illustrate how the signatures and framework can guide patient-specific management.