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Abstract

Objective:

Research on continuous electro-encephalographic monitoring (cEEG) in the intensive care unit (ICU) has previously focused on neuroscience ICUs. This study determines cEEG utilization within a sample of specialty ICUs world-wide.

Methods:

A cross-sectional electronic survey of attending level physicians across various intensive care settings. Twenty-five questions developed from consensus statements on the use of cEEG in the critically ill sent as an electronic survey.

Results:

Of all, 9344 were queried and 417 (4.5%) responses were analyzed with 309 (74%) from the United States and 74 (18%) internationally. Intensive care units were: medical (10%), surgical (6%), neurologic/neurosurgical (12%), cardiac (4%), trauma (3%), pediatrics (29%), burn (<1%), multidisciplinary (30%), and other (5%). Intensive care units were: academic (65%), community (18%), public (3%), military (1%), and other (13%). Specialized cEEG teams were available in 71% of ICUs. Rapid 24/7 access and cEEG interpretation was available in 32% of ICUs. Interpretation changed clinical management frequently (28%) and sometimes (45%).

Conclusions:

Despite guideline recommendations for cEEG use, there is a discordance between availability, night coverage, and immediate interpretation. Only 27% have institutional protocols for indications and duration of cEEG monitoring. Furthermore, cEEG may be underutilized in nonneurologic ICUs as well as ICUs in smaller nonacademic affiliated hospitals and those outside of the United States.

Keywords

electroencephalography (EEG)continuous electroencephalographic monitoring (cEEG)neurocritical care seizures status epilepticus neuromonitoring

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References

Brophy

Bell

Claassen

, et al. Neurocritical care society status epilepticus guideline writing committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23.

Chen

JWY

Wasterlain

. Status epilepticus: pathophysiology and management in adults. Lancet Neurol. 2006;5(3):246–256.

Mazarati

Baldwin

Sankar

Wasterlain

. Time dependent decrease in the effectiveness of antiepileptic drugs during the course of self-sustaining status epilepticus. Brain Res. 1998;814(1-2):179–185.

Claassen

Mayer

Kowalski

Emerson

Hirsch

. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62(10):1743–1748.

Le Roux

Menon

Citerio

, et al. Consensus summary statement on the International Multidisciplinary Consensus Conference on multimodality monitoring in neurocritical care. Intensive Care Med. 2014;40(9):1189–1209.

Abend

Dlugos

Hahn

Hirsch

Herman

. Use of EEG monitoring and management of non-convulsive seizures in critically ill patients: a survey of neurologists. Neurocrit Care. 2010;12(3):382–389.

Gavvala

Abend

LaRoche

, et al. Critical Care EEG monitoring research consortium. continuous EEG monitoring: a survey of neurophysiologists and neurointensivists. Epilepsia. 2014;55(11):1864–1871.

Herman

Abend

Bleck

, et al. Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society. Consensus statement on continuous EEG in critically ill adults and children, part I: indications. J Clin Neurophysiol. 2015;32(2):87–95.

Herman

Abend

Bleck

, et al. Consensus statement on continuous EEG in critically ill adults and children, part II: personnel, technical specifications, and clinical practice. J CLin Neurophysiol. 2015;32(2):96–108.

10.

Halpern

Pastores

Thaler

Greenstein

. Changes in critical care beds and occupancy in the United States 1985-2000: differences attributable to hospital size. Crit Care Med. 2006;34(8):2105–2112.

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Continuous Electroencephalographic Monitoring in the Intensive Care Unit: A Cross-Sectional Study

Abstract

Objective:

Methods:

Results:

Conclusions:

Keywords

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References

Supplementary Material