Comparison Between Deltascan Single Channel Electroencephalography (EEG), Confusion Assessment Method-Intensive Care Unit (CAM-ICU) Score and Clinical Assessment in Diagnosing Delirium in Intubated Patients in the Intensive Care Unit

Background The aim of this article is to assess the feasibility of using single-channel electroencephalography (EEG) measurement for detecting delirium in intubated Intensive care (ICU) patients and to assess the level of agreement between the EEG measurements, the CAM-ICU score and the clinical diagnosis of delirium. Materials and methods This study was an exploratory pilot between May 2021 and September 2021 including intubated patients in the ICU. For this study the Prolira (R) (Arnhem, The Netherlands) Deltascan single-channel EEG was used and compared with the Confusion Assessment Method (CAM)-ICU and the clinical diagnosis of delirium by ICU physicians. Results In total 23 patients were found eligible for this study, of which 20 were included in the final analysis. The patients mean age was 63.0 +/- 8.8 years, and the majority (thirteen) was male (65%). In total 17 of the 20 patients (85%) received the diagnosis delirium by the medical team. There were no statistically significant differences between the Deltascan and CAM-ICU measurements in diagnosing delirium per time point (p values respectively 0.21; 0.90; 0.34; 0.11; 0.056 and 0.091). AUCs for the agreement between the CAM-ICU and the Deltascan measurements were respectively: 0.676 +/- 0.205; 0.333 +/- 0.224; 0.402 +/- 0.146; 0.488 +/- 0.202; 0.06 +/- 0.077 and 0.06 +/- 0.109 (all p>0.05). AUCs for the level of agreement between the clinical diagnosis delirium and Deltascan were: 0.676 +/- 0.152; 0.686 +/- 0.146; 0.711 +/- 0.132; 0.688 +/- 0.136; 0.500 +/- 0.158 and 0.700 +/- 0.211 (all p>0.05). Conclusion In this exploratory study, we showed that there is no statistical agreement between CAM-ICU and Delta scan measurements. Secondly, there is a higher agreement, although not statistically significant between the clinical diagnoses of a delirium (by a clinician) with the Deltascan measurements. Despite this small study we think that the Deltascan can be of additional value in intubated ICU patients and therefore larger studies are needed to substantiate our findings.

Automated summary

This study aimed to assess the feasibility of using single-channel electroencephalography (EEG) measurement for detecting delirium in intubated ICU patients and to evaluate the agreement between EEG measurements, the CAM-ICU score, and the clinical diagnosis of delirium. The results showed no statistical agreement between CAM-ICU and Delta scan measurements, but there was a higher agreement, although not statistically significant, between the clinical diagnosis of delirium and Delta scan measurements. Larger studies are needed to confirm these findings.