AEEG Use in Pediatric Critical Care-An Online Survey.

Nora Bruns,Christian Dohna-Schwake,Ursula Felderhoff-Müser,Joachim Woelfle,Hanna Müller

doi:10.3389/fped.2020.00003

Nora Bruns, Christian Dohna-Schwake + Show 3 more

Open Access

https://doi.org/10.3389/fped.2020.00003

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Abstract

Background: Evidence supporting continuous EEG monitoring in pediatric intensive care is increasing, but continuous full-channel EEG is a scarce resource. Amplitude-integrated EEG (aEEG) monitors are broadly available in children's hospitals due to their use in neonatology and can easily be applied to older patients.Objective: The aim of this survey was to evaluate the use of amplitude-integrated EEG in German and Swiss pediatric intensive care units (PICUs).Design: An online survey was sent to German and Swiss PICUs that were identified via databases provided by the German Pediatric Association (DGKJ) and the Swiss Society of Intensive Care (SGI). The questionnaire contained 18 multiple choice questions including the PICU size and specialization, indications for aEEG use, perceived benefits from aEEG, and data storage.Main results: Forty-three (26%) PICUs filled out the questionnaire. Two thirds of all interviewed PICUs use aEEG in non-neonates. Main indications were neurological complications or disease and altered mental state. Features assessed were mostly seizures and side differences, less frequently height of amplitude and background pattern. Interpretation of raw EEG also played an important role. All interviewees would appreciate the establishment of reference values for toddlers and children.Conclusions: aEEG is used in a large proportion of the interviewed PICUs. The wide-spread use without validation of data generates the need for further evaluation of this technique and the establishment of reference values for non-neonates.

Highlights

Evidence supporting the use of continuous electroencephalography (EEG) in pediatric critical care has increased considerably in recent years
It has been shown that time from pediatric intensive care unit (PICU) admission to continuous EEG is associated with mortality in non-convulsive epileptic state [6]
The following items were assessed in the questionnaire: Multiple answers possible: specialization of PICU, availability of cerebral imaging, Amplitude-integrated EEG (aEEG) indications for all ages including neonates, use of aEEG in patients with altered mental state, qualities assessed in pediatric aEEG, classifications used for pediatric aEEG, perceived benefits at nights and at weekends, advantages of aEEG compared to conventional EEG, site and duration of data storage

Summary

Introduction

Evidence supporting the use of continuous electroencephalography (EEG) in pediatric critical care has increased considerably in recent years It has proven beneficial after cardiac arrest, in patients with altered mental state and for the detection and treatment of seizures and monitoring of anticonvulsive treatment efficiency [1,2,3,4,5]. As continuous video-electroencephalograpy with the full 10–20 system of electrodes represents aEEG in Pediatric Critical Care the gold standard, but remains a scarce resource requiring an epileptologist for interpretation, amplitude-integrated EEG appears to be a promising alternative It is available in a large proportion of neonatal intensive care units and is easy to apply [7]. Amplitude-integrated EEG (aEEG) monitors are broadly available in children’s hospitals due to their use in neonatology and can be applied to older patients

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