Survey of Pediatric ICU EEG Monitoring–Reassessment After a Decade

Abstract

In 2011, the authors conducted a survey regarding continuous EEG (CEEG) utilization in critically ill children. In the interim decade, the literature has expanded, and guidelines and consensus statements have addressed CEEG utilization. Thus, the authors aimed to characterize current practice related to CEEG utilization in critically ill children. Methods:The authors conducted an online survey of pediatric neurologists from 50 US and 12 Canadian institutions in 2022. Results:The authors assessed responses from 48 of 62 (77%) surveyed institutions. Reported CEEG indications were consistent with consensus statement recommendations and included altered mental status after a seizure or status epilepticus, altered mental status of unknown etiology, or altered mental status with an acute primary neurological condition. Since the prior survey, there was a 3-to 4-fold increase in the number of patients undergoing CEEG per month and greater use of written pathways for ICU CEEG. However, variability in resources and workflow persisted, particularly regarding technologist availability, frequency of CEEG screening, communication approaches, and electrographic seizure management approaches.Conclusions: Among the surveyed institutions, which included primarily large academic centers, CEEG use in pediatric intensive care units has increased with some practice standardization, but variability in resources and workflow were persistent.

Survey of Pediatric Status Epilepticus Treatment Practices and Adherence to Management Guidelines (Pedi-SPECTRUM e-Survey)

“… 3 Fung et al performed a survey of cEEG monitoring in PICUs of 48 US and Canadian institutions. 23 The continuous EEG was almost always available at 86% of the US institutions and 18% of the Canadian institutions. The indications for cEEG were generally aligned with the American Clinical Neurophysiology Society indications (84–100%).…”

“…Majority of clinicians (65%) aimed to terminating all nonconvulsive seizures. 23 With increasing availability of cEEG as well as pediatric neurologists, the use of cEEG in PSE is increasing as demonstrated in index eSurvey where 70% respondents use cEEG while managing PSE and 85.3% respondents consider seizure free period of 12–48 hours before tapering third-line ASMs.…”