Evidence map›Paper›PMID 34825115›Full record

ArticleClinical neurophysiology practice2021

Quantitative burst suppression on serial intermittent EEG in refractory status epilepticus.

Joseph Peedicail, Neil Mehdiratta, Shenghua Zhu, Paulina Nedjadrasul, Marcus C Ng

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical neurophysiology practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Using artificial intelligence to optimize anti-seizure treatment and EEG-guided decisions in severe brain injury.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Joseph PeedicailSection of Neurology, University of Manitoba, Winnipeg, MB, Canada.
Neil MehdirattaSection of Neurology, University of Manitoba, Winnipeg, MB, Canada.
Shenghua ZhuDepartment of Radiology, University of Ottawa, Ottawa, ON, Canada.
Paulina NedjadrasulMax Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Marcus C NgSection of Neurology, University of Manitoba, Winnipeg, MB, Canada.
University of Manitoba · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn refractory status epilepticus (RSE), the optimal degree of suppression (EEG burst suppression or merely suppressing seizures) remains unknown. Many centers lacking continuous EEG must default to serial intermittent recordings where uncertainty from lack of data may prompt more aggressive suppression. In this study, we sought to determine whether the quantitative burst suppression ratio (QBSR) from serial intermittent EEG recording is associated with RSE patient outcome.

methodsWe screened the EEG database to identify non-anoxic adult RSE patients for EEG and chart review. QBSR was calculated per 10-second EEG epoch as the percentage of time during which EEG amplitude was <3 µV. Patients who survived 1-3 months after discharge from ICU and hospital comprised the favorable group. Further to initial unadjusted univariate analysis of all pooled QBSR, we conducted multivariate analyses to account for individual patient confounders ("per-capita analysis"), uneven number of EEG recordings ("per-session analysis"), and uneven number of epochs ("per-epoch analysis"). We analyzed gender, anesthetic number, and adjusted status epilepticus severity score (aSTESS) as confounders.

resultsIn 135,765 QBSR values over 160 EEG recordings (median 2.17 h every ≥24 h) from 17 patients on Propofol, Midazolam, and/or Ketamine, QBSR was deeper in the favorable group (

conclusionsThere was no association between depth of EEG suppression using non-barbiturate anesthetic and RSE patient outcome based on QBSR from serial intermittent EEG. A per-epoch association between non-barbiturate anesthetic and favorable outcome suggests an effect from non-suppressive time-varying EEG content. SIGNIFICANCE: Targeting and following deeper burst suppression through non-barbiturate anesthetics on serial intermittent EEG monitoring of RSE is of limited utility.

Indexed as

Burst suppressionIntensive care unitQuantitative EEGRefractory status epilepticusSeizureSerial intermittent monitoring

Identifiers

PMID34825115
PMCPMC8604990
OpenAlexW3209398655

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.