TY - JOUR
T1 - Continuous Electroencephalographic Monitoring in the Intensive Care Unit
T2 - A Cross-Sectional Study
AU - Koffman, Lauren
AU - Rincon, Fred
AU - Gomes, Joao
AU - Singh, Sarabdeep
AU - He, Yitian
AU - Ritzl, Eva
AU - Bleck, Thomas P.
AU - Kaplan, Peter W.
AU - Nyquist, Paul
N1 - Funding Information:
The authors would like to thank the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins who provided us with institutional support from the Zach Sowers Brain Trauma Research Fund. The author(s) received no financial support for the research, authorship, and/or publication of this article.
Funding Information:
The authors would like to thank the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins who provided us with institutional support from the Zach Sowers Brain Trauma Research Fund.
Publisher Copyright:
© The Author(s) 2019.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - 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.
AB - 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.
KW - continuous electroencephalographic monitoring (cEEG)
KW - electroencephalography (EEG)
KW - neurocritical care
KW - neuromonitoring
KW - seizures
KW - status epilepticus
UR - http://www.scopus.com/inward/record.url?scp=85085578422&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85085578422&partnerID=8YFLogxK
U2 - 10.1177/0885066619849889
DO - 10.1177/0885066619849889
M3 - Article
C2 - 31084284
AN - SCOPUS:85085578422
SN - 0885-0666
VL - 35
SP - 1235
EP - 1240
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 11
ER -