Rapid Handheld Continuous Electroencephalogram (EEG) Has the Potential to Detect Delirium in Older Adults.
Malissa A Mulkey, Laura T Gantt, Sonya R Hardin and 7 others
PMID 34817959WHAT IT FOUND
EEG sleep-to-awake ratios were higher in delirium-positive ventilated older adults, but this small pilot cannot show that handheld EEG reliably detects delirium.
Key findings
01Seventeen critically ill older adults requiring mechanical ventilation for more than 12 hours were enrolled, and nine were delirium positive during enrollment.
02Delirium positive subjects had higher delta/theta and theta/alpha EEG ratios than delirium negative subjects, and theta/alpha reached p=0.048.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a small pilot with 17 participants from a single institution, so it cannot establish accuracy. It was not powered for statistical significance, and a properly powered study would require 500 delirious participants. No cut-off scores for EEG ratios were available, so the ratios cannot be used as a diagnostic threshold. One delirium negative subject was excluded from exploratory analyses because of artifact. Patients with unknown focal brain changes or seizure activity may confound results. Severity scores such as APACHE and SOFA were not available.
Declared interests
The authors declared no additional conflicts of interest.
The easy way to misread this
Do not conclude that handheld EEG can reliably detect delirium or replace CAM-ICU. This was a small pilot that was not powered for statistical significance, with 17 participants, no available cut-off scores, and only one ratio reached significance.