Continuous Electroencephalographic Monitoring in Adult ICU Challenges and Potential Solutions: A Scoping Review

Abstract

Background: Continuous electroencephalographic (cEEG) monitoring is continuous monitoring of brain activity that is often used in the intensive care unit (ICU). Recently, the usage of cEEG has grown in many institutions as it detects non-convulsive seizures better than routine EEG (rEEG). However, due to the aggressive environment of ICU, the application and the prolonged recording is challenging. The objectives of this scoping review are to evaluate the common challenges faced during cEEG in adult ICU and proper solutions for optimal implementation. Methods: A scoping review was conducted using Arksey and O’Malley framework. The included articles contain “continuous EEG in ICU settings” in their titles, written in English, and published between 2010 and 2022. That was by searching the databases: PubMed, Google Scholar, and Summon. Results: 14 articles were included as they meet the criteria of this review. (28.57 %) of the included studies mentioned the challenges regarding staff, (42.85 %) addressed the challenges of electrode application and the alternative techniques in ICU, and (42.85%) discussed the difficulties in interpretation and duration of the recording. Conclusion: Continuous EEG is increasingly recognized as valuable mean of monitoring cerebral function, but it is faced with numerous challenges: the difficult environment of ICU and the type of critical patient admitted requiring the optimal electrode application and maintenance, minimizing artifacts and adequate duration of recording to detect abnormalities, and sufficiently trained personnel including ICU staff, technologist and neurophysiologist to provide the optimal patient care as it is the main goal.