Detection and monitoring acute encephalopathy/delirium

Early detection

Objective

Accurate

www.prolira.com V2.0

The term acute encephalopathy refers to a rapidly developing (usually within hours to a few days) pathobiological process (disease) in the brain. Acute encephalopathy often manifests itself as delirium, where the diagnosis is made by means of EEG (Electroencephalography)1,2. Delirium is diagnosed based on clinical features. Both diagnoses are characterized by an underlying cause (suffering). Research shows that only 12% to 35% of delirious patients are recognized with current screening tools3.

Acute encephalopathy and delirium

DeltaScan is an objective medical device that can be used to assess the condition

of the brain. The DeltaScan Monitor is CE-certified under the EU-MDR and

works on the basis of a 1-channel EEG signal.

Polymorphic delta wavesImmediately after the measurement, which takes only a few minutes, the DeltaScan Score is visible on a scale from 1 to 5, where 1 means “very unlikely acute encephalopathy/delirium” and 5 means “very likely acute encephalopathy/delirium”. Both acute encephalopathy and delirium are characterized by strong and very slow waves in the EEG.2,4,5,6

These waves are called polymorphic delta waves and are a proven biomarker for both acute encephalopathy and delirium.2,5,7 Polymorphic delta waves are not present in the healthy and awake person. Figure 1 shows the DeltaScan Scores with corresponding EEGs, clearly showing a difference between DeltaScan Score 1 and DeltaScan Score 5.

DeltaScan® Brain State MonitorThe use of DeltaScan makes it possible to detect acute encephalopathy and delirium more often (> 85% accuracy) and earlier (on average 1 to 1.5 days) compared to current practice in which usual (regular) questionnaires are used8.

DeltaScan supports you in your clinical decision-making in the following ways:• Insight into the degree of illness of the patient based on the

presence / absence of polymorphic delta waves in the EEG (brain status) and the adjustment of the treatment plan accordingly

• Determine an underlying cause earlier of acute encephalopathy/delirium and thus detect postoperative complications earlier

• Monitoring the effect of treatment of the underlying cause and of (non) pharmacological interventions

• Reconsider the treatment plan for persistent acute encephalopathy/delirium to avoid as much permanent cognitive residual damage as possible

The implementation of DeltaScan and a clinical protocol for monitoring measurements can possibly shorten the patient's length of stay and prevent cognitive damage and deterioration in daily functioning.

Figure 1

DeltaScan EEG

DeltaScan EEG

DeltaScan EEG

DeltaScan EEG

DeltaScan EEG

Very unlikelyacute encephalopathy/delirium

Unlikelyacute eencephalopathy/delirium

Possiblyacute encephalopathy/delirium

Likelyacute encephalopathy/delirium

Very likelyacute encephalopathy/delirium

References1. Slooter et al., 2020, Intensive Care Med, 46: 1020–10222. Hut et al., 2021 Psychiatry and Clinical Neurosciences3. Marcantonio, 2017, N Engl J Med, 377(15): 1456-14664. Kimchi et al., 2019, Neurology, 93: e1-e125. Van der Kooij et al., 2015, Chest, 147(1): 94-1016. Tanabe et al., 2020, Br. J. Anaesth, 125(1): 55-667. Numan et al., 2019, Br. J. Anaesth, 122(1): 60-688. Unpublished data, available on request

www.prolira.com