Continuous EEG Monitoring in the Intensive Care Unit

Hirsch, Lawrence J.; Kull, Lewis L.

doi:10.1080/1086508x.2004.11079478

Cited by 84 publications

(97 citation statements)

References 24 publications

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“…Given the expanding indications to perform continuous EEG monitoring in the ICU [15], as well as the need for frequent neuroimaging in these patients, and given the high-quality EEG recording, we have begun to routinely use CPEs in all patients in the ICU undergoing EEG monitoring. We propose that these electrodes should be routinely used in all patients undergoing EEG monitoring in the ICU as it enhances patient care by promoting prompt acquisition of MRI and CT scans without adverse effects to the patient.…”

Section: Resultsmentioning

confidence: 99%

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The Utility of Conductive Plastic Electrodes in Prolonged ICU EEG Monitoring

et al. 2008

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We investigated the feasibility and utilization of conductive plastic electrodes (CPEs) in patients undergoing continuous video-electroencephalographic (EEG) monitoring in the intensive care unit (ICU), and assessed the quality of brain magnetic resonance imaging (MRI) and computed tomography (CT) images obtained during this period. A total of 54 patients were monitored. Seizures were recorded in 16 patients. Twenty-five patients had neuroimaging performed with electrodes in place; 15 MRI and 23 CT scans were performed. All patients had excellent quality anatomical images without clinically significant artifacts, and without any signs or symptoms that raised safety concerns. Recording quality of the EEG was indistinguishable to that achieved with standard gold electrodes. The use of CPEs allowed for uninterrupted EEG recording of patients who required urgent neuroimaging, and decreased the amount of time spent by the technologists required to remove and reattach leads.

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Section: Resultsmentioning

confidence: 99%

“…This study included consecutive patients undergoing continuous video EEG monitoring in the ICU between January 1, 2008 and May 15,2008. No patients were excluded from this study unless insufficient CPEs were available; in those instances, patients who were more likely to require neuroimaging were preferentially selected.…”

Section: Methodsmentioning

confidence: 99%

The Utility of Conductive Plastic Electrodes in Prolonged ICU EEG Monitoring

et al. 2008

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“…Indeed, some authors suggest that cEEG will soon be the standard of care [3,6]. The current report demonstrates the suitability of SWE for use in a comatose patient during cEEG with possible advantages from the technical, patient safety, and staff resource perspectives.…”

Section: Discussionmentioning

confidence: 82%

“…Reported average durations of EEG monitoring range from 2.9 to 7 days, with maximal duration up to 42 days [2,8,[20][21][22][23]. There is evidence demonstrating that seizures in comatose patients may be missed unless at least 7 days of cEEG is performed [3,24]. Vespa et al [2] demonstrated that status epilepticus after Fig.…”

Section: Discussionmentioning

confidence: 96%

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Sixty Day Continuous Use of Subdermal Wire Electrodes for EEG Monitoring During Treatment of Status Epilepticus

2009

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Diagnostic accuracy between readers for identifying electrographic seizures in critically ill adults

Young

Kokoszka

et al. 2017

Epilepsia Open

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SummaryObjectiveElectrographic seizures in critically ill patients are often equivocal. In this study, we sought to determine the diagnostic accuracy of electrographic seizure annotation in adult intensive care units (ICUs) and to identify affecting factors.MethodsTo investigate diagnostic accuracy, interreader agreement (IRA) measures were derived from 5,769 unequivocal and 6,263 equivocal seizure annotations by five experienced electroencephalogram (EEG) readers after reviewing 74 days of EEGs from 50 adult ICU patients. Factors including seizure equivocality (unequivocal vs. equivocal) and laterality (generalized, partial, or bilaterally independent), cyclicity (cyclic vs. noncyclic), persistency (occurrence of status epilepticus), and patient consciousness level (coma vs. noncoma) were further investigated for their influence on IRA measures.ResultsOn average, 70% of seizures marked by a reference reader overlapped, at least in part, with those marked by a test reader (any‐overlap sensitivity, AO‐Sn). Agreed seizure duration between reader pairs (overlap‐integral sensitivity, OI‐Sn) was 62%, while agreed nonseizure duration (overlap‐integral specificity, OI‐Sp) was 99%. A test reader would annotate one additional seizure not overlapping with a reference reader's annotation in every 11.7 h of EEG, that is, the false‐positive rate (FPR) was 0.0854/h. Classifying seizure patterns into unequivocal and equivocal improved specificity and FPR (unequivocal patterns) but compromised sensitivity only for equivocal patterns. Sensitivity of all and unequivocal annotations was higher for patients with status epilepticus. Specificity was higher for partial than for bilaterally independent unequivocal seizure patterns, and lower for cyclic all seizure patterns.SignificanceDiagnosing electrographic seizures in critically ill adults is highly specific and moderately sensitive. Improved criteria for diagnosing electrographic seizures in the ICU are needed.

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Continuous EEG Monitoring in the Intensive Care Unit

Cited by 84 publications

References 24 publications

The Utility of Conductive Plastic Electrodes in Prolonged ICU EEG Monitoring

The Utility of Conductive Plastic Electrodes in Prolonged ICU EEG Monitoring

Sixty Day Continuous Use of Subdermal Wire Electrodes for EEG Monitoring During Treatment of Status Epilepticus

Diagnostic accuracy between readers for identifying electrographic seizures in critically ill adults

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