The yield of continuous EEG monitoring in the intensive care unit at a tertiary care hospital in Saudi Arabia: A retrospective study.

Haythum O Tayeb

doi:10.12688/f1000research.19237.1

Abstract

Background: The practice of continuous EEG monitoring (CEEG) in the intensive care unit (ICU) has been spreading over the past decade. Building an effective ICU CEEG program with sufficient quality demands adequate EEG equipment and significant human resources. While this is available in large tertiary care centers where the practice of CEEG has developed, it may not be available in developing healthcare systems. This study sought to provide data generated from a CEEG program in the adult ICU at a tertiary healthcare center in Saudi Arabia, shedding light on the real-life utility of CEEG in a developing healthcare system. Methods: This is a retrospective review of CEEG findings, along with mortality and duration of hospitalization of patients who had CEEG during a 12-month period at the adult ICU at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Results: A total of 202 CEEG records were identified. A total of 52 patients had non-convulsive seizures (NCS); 10 clearly fulfilled criteria for non-convulsive status epilepticus. There were 120 patients that had clinical seizures upon presentation. Among them, 36 (30%) had NCS on EEG. The proportion of patients who were deceased at 60 days was higher in patients who had NCS (42%) than those who didn't (26%, χ 2 (2, n=200)= 4.4, p=0.03). The duration of hospital stay was longer for those who had periodic or rhythmic CEEG patterns (χ 2 (2, n=200)= 7.6, p=0.02) but there was no significant relationship with mortality at 60 days. Conclusion: This study demonstrates a real-world experience from a tertiary care center in Saudi Arabia, a developing healthcare system. Findings are consistent with prior experience with ICU CEEG, demonstrating that finding ictal, rhythmic or periodic patterns is associated with morbidity and mortality. Further studies are needed to demonstrate how the practice of CEEG may alter patient outcomes.

Highlights

Continuous electroencephalography (CEEG), the practice of continuously recording an electroencephalogram and a timesynchronized video of the patient, is commonly utilized to monitor critically ill patients with acute brain injury or altered mental status[1]
Building an effective intensive care unit (ICU) continuous EEG monitoring (CEEG) program with sufficient quality demands adequate EEG equipment and significant human resources[2]. This includes trained electroencephalographers and technologists who have enough time to devote to reviewing the large amounts of EEG data that are generated through continuous monitoring[2]. While this is available in large tertiary care centers where the practice of CEEG has developed, it may not be available in developing healthcare systems
Data gathering This is a retrospective review of ICU CEEG findings, as well as mortality status and duration of hospitalization of all patients who underwent CEEG monitoring during a 12-month period from September 2016 to August 2017 at the adult ICU at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia

Summary

Introduction

Continuous electroencephalography (CEEG), the practice of continuously recording an electroencephalogram and a timesynchronized video of the patient, is commonly utilized to monitor critically ill patients with acute brain injury or altered mental status[1]. Building an effective ICU CEEG program with sufficient quality demands adequate EEG equipment and significant human resources[2] This includes trained electroencephalographers and technologists who have enough time to devote to reviewing the large amounts of EEG data that are generated through continuous monitoring[2]. While this is available in large tertiary care centers where the practice of CEEG has developed, it may not be available in developing healthcare systems. Building an effective ICU CEEG program with sufficient quality demands adequate EEG equipment and significant human resources Further studies are needed to demonstrate how the practice of CEEG may alter patient outcomes

Methods

Results

Conclusion