title: EEG changes and serum anticholinergic activity measured in patients with delirium in the intensive care unit.
abstract: The aim of this study was to examine whether serum anticholinergic activity (SAA) is a reliable indicator of delirium in the ICU, and whether there is a significant correlation between SAA and quantitative electroencephalographic (EEG) data in delirious patients. In a prospective cohort study, we assessed ICU patients diagnosed with delirium (n = 37). EEG measurements and blood analysis including SAA were performed 48 h following ICU admission. The presence of delirium was evaluated using the Confusion Assessment Method for critically ill patients in ICU (CAM-ICU). The SAA level was measured using a competitive radioreceptor binding assay for muscarinergic receptors and quantitative EEG was measured using the CATEEM system. We found that, under comparable conditions, patients in the delirium group showed a higher relative EEG theta power and a reduced alpha power (n = 17) than did the non-delirious patients (n = 20). No difference in measured SAA levels were seen; therefore, there was no correlation between SAA and EEG measurements in delirious patients. We conclude that, in contrast to the EEG, the SAA level cannot be proposed as a tool for diagnosing delirium in ICU patients.
authors.affiliation: Department of Anaesthesiology, Medical Faculty of the University of Heidelberg, Germany. konstanze.plaschke@med.uni-heidelberg.de
authors.forename: K
authors.initials: K
authors.lastname: Plaschke
authors.forename: H
authors.initials: H
authors.lastname: Hill
authors.forename: R
authors.initials: R
authors.lastname: Engelhardt
authors.forename: C
authors.initials: C
authors.lastname: Thomas
authors.forename: R
authors.initials: R
authors.lastname: von Haken
authors.forename: M
authors.initials: M
authors.lastname: Scholz
authors.forename: J
authors.initials: J
authors.lastname: Kopitz
authors.forename: H J
authors.initials: HJ
authors.lastname: Bardenheuer
authors.forename: M
authors.initials: M
authors.lastname: Weisbrod
authors.forename: M A
authors.initials: MA
authors.lastname: Weigand
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D018680:Cholinergic Antagonists / Q000097:blood*; D003693:Delirium / Q000097:blood / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012815:Signal Processing, Computer-Assisted
chemical_list: D015415:Biomarkers; D018680:Cholinergic Antagonists