Publications by authors named "Parimala Krishnamurthy"

Background: Identical bursts on electroencephalography (EEG) are considered a specific predictor of poor outcomes in cardiac arrest, but its relationship with structural brain injury severity on magnetic resonance imaging (MRI) is not known.

Methods: This was a retrospective analysis of clinical, EEG, and MRI data from adult comatose patients after cardiac arrest. Burst similarity in first 72 h from the time of return of spontaneous circulation were calculated using dynamic time-warping (DTW) for bursts of equal (i.

View Article and Find Full Text PDF

Background And Objectives: Approximately 30% of critically ill patients have seizures, and more than half of these seizures do not have an overt clinical correlate. EEG is needed to avoid missing seizures and prevent overtreatment with antiseizure medications. Conventional-EEG (cEEG) resources are logistically constrained and unable to meet their growing demand for seizure detection even in highly developed centers.

View Article and Find Full Text PDF

Purpose: There is frequent delay between ordering and placement of conventional EEG. Here we estimate how many patients had seizures during this delay.

Methods: Two hundred fifty consecutive adult patients who underwent conventional EEG monitoring at the University of Wisconsin Hospital were retrospectively chart reviewed for demographics, time of EEG order, clinical and other EEG-related information.

View Article and Find Full Text PDF

Intensive care units (ICUs) may disrupt sleep. Quantitative ICU studies of concurrent and continuous sound and light levels and timings remain sparse in part due to the lack of ICU equipment that monitors sound and light. Here, we describe sound and light levels across three adult ICUs in a large urban United States tertiary care hospital using a novel sensor.

View Article and Find Full Text PDF

To measure sleep in the intensive care unit (ICU), full polysomnography is impractical, while activity monitoring and subjective assessments are severely confounded. However, sleep is an intensely networked state, and reflected in numerous signals. Here, we explore the feasibility of estimating conventional sleep indices in the ICU with heart rate variability (HRV) and respiration signals using artificial intelligence methods We used deep learning models to stage sleep with HRV (through electrocardiogram) and respiratory effort (through a wearable belt) signals in critically ill adult patients admitted to surgical and medical ICUs, and in age and sex-matched sleep laboratory patients We studied 102 adult patients in the ICU across multiple days and nights, and 220 patients in a clinical sleep laboratory.

View Article and Find Full Text PDF
Article Synopsis
  • Dementia is increasingly common among the elderly but is often underdiagnosed; early detection through sleep patterns could help improve management of the disease.
  • The study analyzed sleep data from over 8,000 participants, classifying them into dementia, mild cognitive impairment, or cognitively normal groups using various predictive models.
  • Results showed that the models could effectively differentiate between dementia and normal cognition, highlighting the potential of sleep EEGs for routine dementia screenings.
View Article and Find Full Text PDF

Identifying and treating critically ill patients with seizures can be challenging. In this article, the authors review the available data on patient populations at risk, seizure prognostication with tools such as 2HELPS2B, electrographic seizures and the various ictal-interictal continuum patterns with their latest definitions and associated risks, ancillary testing such as imaging studies, serum biomarkers, and invasive multimodal monitoring. They also illustrate 5 different patient scenarios, their treatment and outcomes, and propose recommendations for targeted treatment of electrographic seizures in critically ill patients.

View Article and Find Full Text PDF

Purpose: Sleep-disordered breathing may be induced by, exacerbate, or complicate recovery from critical illness. Disordered breathing during sleep, which itself is often fragmented, can go unrecognized in the intensive care unit (ICU). The objective of this study was to investigate the prevalence, severity, and risk factors of sleep-disordered breathing in ICU patients using a single respiratory belt and oxygen saturation signals.

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to create a grading system for assessing the severity of acute encephalopathy (delirium or coma) using EEG data, and to analyze how this system relates to clinical outcomes like functional status and mortality.
  • The research was conducted at an academic medical center over a span of several years, focusing on adult inpatients with clinical EEG recordings, while excluding certain patients based on specific criteria.
  • The findings suggest that the newly developed Visual EEG Confusion Assessment Method Severity (VE-CAM-S) scores are highly correlated with established behavioral assessments of delirium severity, and they can effectively predict various clinical outcomes.
View Article and Find Full Text PDF