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P332 The development of NCUs in China: A 2nd nationwide survey
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Abstracts / Clinical Neurophysiology 128 (2017) e178–e303
(P = 0.004, 0.003 respectively). The sensitivity and specificity for poor outcome for amplitude of O1 higher than 2.7 was 63.3% and 44.4% respectively, O2 higher than 2.4 was 68.2% and 44.4% respectively and Cz higher than 1.5 was 68.2% 50% respectively. In conclusion: The correlation between EEG data and global functional outcome are possibly confident within 72 h.
Significance: The results of this survey could expose deficiencies in Chinese NCUs development so that they can be studied and the suggestions can be provided for a more sustainable development of NCUs.
Keywords: Cardiac arrest, Conventional EEG, Quantitative electroencephalography
doi:10.1016/j.clinph.2017.07.340
doi:10.1016/j.clinph.2017.07.339
P332 The development of NCUs in China: A 2nd nationwide survey—Yingying Su 1, Suyue Pan 2, Wen Jiang 3, Furong Wang 4, Le Zhang 5, Zhenhai Wang 6, Bin Peng 7, Xusheng Huang 8 (1 Xuanwu Hospital, Capital Medical University, Neurology, Beijing, China, 2 Nanfang Hospital, Southern Medical University, Neurology, Guangdong, China, 3 Xijing Hospital, Fourth Military Medical University, Neurology, Xian, China, 4 Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Neurology, Wuhan, China, 5 Xiangya Hospital Central South University, Neurology, Changsha, China, 6 General Hospital of Ningxia Medical University, Neurology, Ningxia, China, 7 Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Neurology, Beijing, China, 8 Chinese People’s Liberation Army General Hospital, Neurology, Beijing, China) Objectives: This report presents results of the 2nd nationwide survey concerning neurocritical care units (NCUs) in China. Methods: This is an observational cross-sectional survey and close-ended self-reported questions were used. The questionnaire was sent to 31 different provinces (autonomous regions and municipalities) across China from October 1st, 2015 to January 1st, 2016. Basic information, equipment and device information, and staffing and organization information were investigated. Results: In total, 101 questionnaires from 101 NCUs at 92 hospitals in 28 regions were received. Most of the hospitals with NCUs were large-scale (average hospital beds: 2150), teaching (84.8%), and tertiary hospitals (97.8%). The average number of NCU beds was 14, occupying 11.2% of the total number of beds in their department. Most of the equipment and devices (37/50) were available in over 80% of the 101 NCUs. However, some devices were centralized by hospital and operated with assistance from other departments. A total of 1250 full-time doctors and 1978 full-time nurses were employed at the NCUs. A few of the NCUs achieved a doctor-tobed ratio of 0.5:1 (40.6%) and a nurse-to-bed ratio of 1:1 (37.6%). And respiratory therapists, clinical dieticians, clinical pharmacists, and physiotherapists were present in 5.9%, 32.7%, 36.6% and 49.5% of the 101 NCUs. Discussion: According to this survey, the number of Chinese NCUs rose 32.9%, to 101 in 2015 from 76 in 2010. Among the 101 NCUs included in this survey, most of the basic devices and specialized devices were sufficiently available. But few NCUs (50%) have their own specialized equipment. Compared with the year 2010, the number of neurocritical care doctors and nurses is significantly higher in 2015. The staffing data of the 101 NCUs still reflect a severe shortage of NCU doctors and nurses. Conclusion: The number of NCUs increased, the availability of NCU equipment became more sufficient, and the staffing of NCUs improved. However, we should pay attention to the management of specialized NCU equipment, the shortage of NCU staff, and the need of NCU training.
Keywords: Neurocritical care, Neurocritical care unit, Crosssectional study, China, Organization, Equipment, Occupancy
P334 Value of electrophysiological studies in detecting lumbosacral radiculopathy in patients with questionable MRI findings—Heba Raafat 1, Wael El Mahdy 2, Waleed Raafat 2, Omar El Falaky 3 (1 Cairo University, Clinical Neurophysiology, Cairo, Egypt, 2 Cairo University, Department of Neurosurgery, Cairo, Egypt, 3 Cairo University, Neurosurgery, Cairo, Egypt) Objective: To test value of electrophysiologic studies in confirming lumbo-sacral radiculopathies in patients with questionable MRI findings for nerve root compression. Methods: The study was conducted on 80 adult patients with sciatica, weakness of myotomal distribution in one limb, hypoesthesia in dermatomal distribution, all with MRI findings of focal disc protrusion/bulge with questionable nerve root compromise not correlating with the clinical symptoms. Results: 25% of cases were acute, 60% subacute, and 15% were chronic. Clinical picture was sciatica with +ve SLRT in 35% of cases, L5 myotomal weakness in 30% of cases, S1 myotomal weakness 15% of cases, L5/S1 myotomal weakness in 15% of cases, sensory deficit in 4% of cases, back pain in 1.25% of cases. Positive EMG findings were found in 96.3% of cases, 96.3% had +ve lower limb findings, 57.5% had +ve paraspinal muscles findings, 70% had small CMAP amplitude, and 7.5% had active denervating potentials. 44% of cases were treated conservatively, while 56% of cases underwent surgery. There was a statistically significant association between the EMG results and clinical picture of radiculopathy, while there was no statistical significance between the MRI findings and the clinical picture of radiculopathy. Conclusion: Electrophysiological studies are efficacious in diagnosing and predicting prognosis of lumbo-sacral radiculopathies. Significance: The proper management decision should be based on the triad of imaging, electrophysiological tests and clinical context. Discussion: MRI accuracy in detecting nerve root compromise is questionable by conflicting reports including this study. Keywords: Electrophysiological studies, Lumbo-sacral MRI Lumbosacral radiculopathy doi:10.1016/j.clinph.2017.07.342
P335 Comparison of median nerve distal motor responses in patients with chronic inflammatory demyelinating polyneuropathy and carpal tunnel syndrome—Zehra Aktan, Eren Gozke *, Nimet Dortcan, Pelin Dogan Ak, Isil Kalyoncu Aslan (FSM Teaching and Research Hospital, University of Health Sciences, Department of Neurology, Istanbul, Turkey) Objective: Dispersion of distal compound muscle action potential (CMAP) is a useful finding for showing demyelination. In this study, we aimed to compare the duration and area of CMAP of median nerve between cases with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Carpal Tunnel Syndrome (CTS).
Abstracts / Clinical Neurophysiology 128 (2017) e178–e303
(P = 0.004, 0.003 respectively). The sensitivity and specificity for poor outcome for amplitude of O1 higher than 2.7 was 63.3% and 44.4% respectively, O2 higher than 2.4 was 68.2% and 44.4% respectively and Cz higher than 1.5 was 68.2% 50% respectively. In conclusion: The correlation between EEG data and global functional outcome are possibly confident within 72 h.
Significance: The results of this survey could expose deficiencies in Chinese NCUs development so that they can be studied and the suggestions can be provided for a more sustainable development of NCUs.
Keywords: Cardiac arrest, Conventional EEG, Quantitative electroencephalography
doi:10.1016/j.clinph.2017.07.340
doi:10.1016/j.clinph.2017.07.339
P332 The development of NCUs in China: A 2nd nationwide survey—Yingying Su 1, Suyue Pan 2, Wen Jiang 3, Furong Wang 4, Le Zhang 5, Zhenhai Wang 6, Bin Peng 7, Xusheng Huang 8 (1 Xuanwu Hospital, Capital Medical University, Neurology, Beijing, China, 2 Nanfang Hospital, Southern Medical University, Neurology, Guangdong, China, 3 Xijing Hospital, Fourth Military Medical University, Neurology, Xian, China, 4 Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Neurology, Wuhan, China, 5 Xiangya Hospital Central South University, Neurology, Changsha, China, 6 General Hospital of Ningxia Medical University, Neurology, Ningxia, China, 7 Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Neurology, Beijing, China, 8 Chinese People’s Liberation Army General Hospital, Neurology, Beijing, China) Objectives: This report presents results of the 2nd nationwide survey concerning neurocritical care units (NCUs) in China. Methods: This is an observational cross-sectional survey and close-ended self-reported questions were used. The questionnaire was sent to 31 different provinces (autonomous regions and municipalities) across China from October 1st, 2015 to January 1st, 2016. Basic information, equipment and device information, and staffing and organization information were investigated. Results: In total, 101 questionnaires from 101 NCUs at 92 hospitals in 28 regions were received. Most of the hospitals with NCUs were large-scale (average hospital beds: 2150), teaching (84.8%), and tertiary hospitals (97.8%). The average number of NCU beds was 14, occupying 11.2% of the total number of beds in their department. Most of the equipment and devices (37/50) were available in over 80% of the 101 NCUs. However, some devices were centralized by hospital and operated with assistance from other departments. A total of 1250 full-time doctors and 1978 full-time nurses were employed at the NCUs. A few of the NCUs achieved a doctor-tobed ratio of 0.5:1 (40.6%) and a nurse-to-bed ratio of 1:1 (37.6%). And respiratory therapists, clinical dieticians, clinical pharmacists, and physiotherapists were present in 5.9%, 32.7%, 36.6% and 49.5% of the 101 NCUs. Discussion: According to this survey, the number of Chinese NCUs rose 32.9%, to 101 in 2015 from 76 in 2010. Among the 101 NCUs included in this survey, most of the basic devices and specialized devices were sufficiently available. But few NCUs (50%) have their own specialized equipment. Compared with the year 2010, the number of neurocritical care doctors and nurses is significantly higher in 2015. The staffing data of the 101 NCUs still reflect a severe shortage of NCU doctors and nurses. Conclusion: The number of NCUs increased, the availability of NCU equipment became more sufficient, and the staffing of NCUs improved. However, we should pay attention to the management of specialized NCU equipment, the shortage of NCU staff, and the need of NCU training.
Keywords: Neurocritical care, Neurocritical care unit, Crosssectional study, China, Organization, Equipment, Occupancy
P334 Value of electrophysiological studies in detecting lumbosacral radiculopathy in patients with questionable MRI findings—Heba Raafat 1, Wael El Mahdy 2, Waleed Raafat 2, Omar El Falaky 3 (1 Cairo University, Clinical Neurophysiology, Cairo, Egypt, 2 Cairo University, Department of Neurosurgery, Cairo, Egypt, 3 Cairo University, Neurosurgery, Cairo, Egypt) Objective: To test value of electrophysiologic studies in confirming lumbo-sacral radiculopathies in patients with questionable MRI findings for nerve root compression. Methods: The study was conducted on 80 adult patients with sciatica, weakness of myotomal distribution in one limb, hypoesthesia in dermatomal distribution, all with MRI findings of focal disc protrusion/bulge with questionable nerve root compromise not correlating with the clinical symptoms. Results: 25% of cases were acute, 60% subacute, and 15% were chronic. Clinical picture was sciatica with +ve SLRT in 35% of cases, L5 myotomal weakness in 30% of cases, S1 myotomal weakness 15% of cases, L5/S1 myotomal weakness in 15% of cases, sensory deficit in 4% of cases, back pain in 1.25% of cases. Positive EMG findings were found in 96.3% of cases, 96.3% had +ve lower limb findings, 57.5% had +ve paraspinal muscles findings, 70% had small CMAP amplitude, and 7.5% had active denervating potentials. 44% of cases were treated conservatively, while 56% of cases underwent surgery. There was a statistically significant association between the EMG results and clinical picture of radiculopathy, while there was no statistical significance between the MRI findings and the clinical picture of radiculopathy. Conclusion: Electrophysiological studies are efficacious in diagnosing and predicting prognosis of lumbo-sacral radiculopathies. Significance: The proper management decision should be based on the triad of imaging, electrophysiological tests and clinical context. Discussion: MRI accuracy in detecting nerve root compromise is questionable by conflicting reports including this study. Keywords: Electrophysiological studies, Lumbo-sacral MRI Lumbosacral radiculopathy doi:10.1016/j.clinph.2017.07.342
P335 Comparison of median nerve distal motor responses in patients with chronic inflammatory demyelinating polyneuropathy and carpal tunnel syndrome—Zehra Aktan, Eren Gozke *, Nimet Dortcan, Pelin Dogan Ak, Isil Kalyoncu Aslan (FSM Teaching and Research Hospital, University of Health Sciences, Department of Neurology, Istanbul, Turkey) Objective: Dispersion of distal compound muscle action potential (CMAP) is a useful finding for showing demyelination. In this study, we aimed to compare the duration and area of CMAP of median nerve between cases with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) and Carpal Tunnel Syndrome (CTS).