Continuous electroencephalography in the intensive care unit: A critical review and position statement from an Australian and New Zealand perspective

Waak, Michaela; Laing, Joshua; Nagarajan, Lakshmi; Lawn, Nicholas; Harvey, A. Simon

doi:10.1016/j.ccrj.2023.04.004

Cited by 1 publication

(1 citation statement)

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“…cEEG studies are not widely used, possibly because they are expensive and labor intensive. In addition, in 2021, the American Clinical Neurophysiology Society (ACNS) updated their guidelines regarding the standardization of critical care EEG terminology to prevent potential misinterpretation or overinterpretation [ 14 , 15 , 16 ]; however, the widespread uptake of standardized terminology requires a considerable amount of time.…”

Section: Introductionmentioning

confidence: 99%

The Role of Routine Electroencephalography in the Diagnosis of Seizures in Medical Intensive Care Units

Hsiao,

Chen,

Chen

et al. 2024

Diagnostics

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Seizures should be diagnosed and treated to ensure optimal health outcomes in critically ill patients admitted in the medical intensive care unit (MICU). Continuous electroencephalography is still infrequently used in the MICU. We investigated the effectiveness of routine EEG (rEEG) in detecting seizures in the MICU. A total of 560 patients admitted to the MICU between October 2018 and March 2023 and who underwent rEEG were reviewed. Seizure-related rEEG constituted 47% of all rEEG studies. Totally, 39% of the patients experienced clinical seizures during hospitalization; among them, 48% experienced the seizure, and 13% experienced their first seizure after undergoing an rEEG study. Seventy-seven percent of the patients had unfavorable short-term outcomes. Patients with cardiovascular diseases were the most likely to have the suppression/burst suppression (SBS) EEG pattern and the highest mortality rate. The rhythmic and periodic patterns (RPPs) and electrographic seizure (ESz) EEG pattern were associated with seizures within 24 h after rEEG, which was also related to unfavorable outcomes. Significant predictors of death were age > 59 years, the male gender, the presence of cardiovascular disease, a Glasgow Coma Scale score ≤ 5, and the SBS EEG pattern, with a predictive performance of 0.737 for death. rEEG can help identify patients at higher risk of seizures. We recommend repeated rEEG in patients with ESz or RPP EEG patterns to enable a more effective monitoring of seizure activities.

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Section: Introductionmentioning

confidence: 99%