scholarly journals Continuous EEG Monitoring in Intensive Care Unit

2018 ◽  
Vol 05 (02) ◽  
pp. 062-067
Author(s):  
Anuja Patil ◽  
Sudhindra Vooturi ◽  
Sita Jayalakshmi

AbstractTrends of electroencephalogram (EEG) over 24 to 48 hours can help in prognostication in patients. Continuous electroencephalography (cEEG) allows for “real-time” bedside evaluation of cerebral function and can help to monitor patients in intensive care units. Lack of expertise in interpretation of the long-term EEG patterns and controversies in treatment implications have restricted the widespread use of this modality. This review summarizes the indications, techniques, duration, and pitfalls in cEEG monitoring. Compared with routine planned EEG, use of cEEG monitoring increases the sensitivity to detect nonconvulsive seizures (NCS) or nonconvulsive status epilepticus (NCSE) in unresponsive patients with no or subtle clinical signs of seizures. cEEG helps in reducing the overall intensive care unit (ICU) stay by timely detection of possible ischemic or ictal insults, alleviating the need for costlier imaging tests, and by precise drug adjustment in case of SE. However, standardization of the technical terms for wider applicability is needed. Analysis of automated computerized assays in seizure detection and their clinical role and addressing the technical aspects in long-term recordings should be evaluated; cEEG is gaining an important role in the multiparametric neuro-critical care units. Development of defined guidelines for the indications and application of cEEG, technological advances, and ongoing refinements are expected to enhance its utility in clinical practice.

Author(s):  
John Kay

AbstractBackground:Electroencephalography (EEG) is playing an increasingly important role in the management of comatose patients in the intensive care unit.Methods:The techniques of EEG monitoring are reviewed. Initially, standard, discontinuous recordings were performed in intensive care units (ICUs). Later, continuous displays of “raw EEG” (CEEG) were used. More recently, the addition of quantitative techniques allowed for more effective reading.Results and Conclusions:Applications of continuous EEG to clinical problems are discussed. The most useful role of CEEG appears to be the detection and management of nonconvulsive seizures. There is a need for controlled studies to assess the role for CEEG in neuro-ICUs and general ICUs.


2020 ◽  
Vol 36 (1) ◽  
pp. 38-47
Author(s):  
Akiyoshi Akiyama ◽  
Jeng-Dau Tsai ◽  
Emily W. Y. Tam ◽  
Daphne Kamino ◽  
Cecil Hahn ◽  
...  

The purpose of this study is to investigate whether listening to music and white noise affects functional connectivity on scalp electroencephalography (EEG) in neonates in the neonatal intensive care unit. Nine neonates of ≥34 weeks’ gestational age, who were already undergoing clinical continuous EEG monitoring in the neonatal intensive care unit, listened to lullaby-like music and white noise for 1 hour each separated by a 2-hour interval of no intervention. EEG segments during periods of music, white noise, and no intervention were band-pass filtered as delta (0.5-4 Hz), theta (4-8 Hz), lower alpha (8-10 Hz), upper alpha (10-13 Hz), beta (13-30 Hz), and gamma (30-45 Hz). Synchronization likelihood was used as a measure of connectivity between any 2 electrodes. In theta, lower alpha, and upper alpha frequency bands, the synchronization likelihood values yielded statistical significance with sound (music, white noise and no intervention) and with edge (between any 2 electrodes) factors. In theta, lower alpha, and upper alpha frequency bands, statistical significance was obtained between music and white noise ( t = 3.12, 3.32, and 3.68, respectively; P < .017), and between white noise and no intervention ( t = 4.51, 3.09, and 2.95, respectively, P < .017). However, there was no difference between music and no intervention. Although limited by a small sample size and the 1-time only auditory intervention, these preliminary results demonstrate the feasibility of EEG connectivity analyses even at bedside in neonates on continuous EEG monitoring in the neonatal intensive care unit. They also point to the possibility of detecting significant changes in functional connectivity related to the theta and alpha bands using auditory interventions.


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