Continuous EEG monitoring in a paediatric intensive care unit.
Monitoring with continuous EEG (cEEG) has become a valuable tool in the adult neurointensive care unit. The benefits of cEEG or amplitude-integrated EEG in neonatal intensive care have also been described. The aim of the present study was to describe and evaluate the use of cEEG in a paediatric intensive care unit. The study is a description of children and adolescents with acute neurological disorders monitored by cEEG in a paediatric intensive care unit for more than 12h. The indication for cEEG and the outcome are reported for 54 patients during a 4-year period. Twelve patients were monitored for high intracranial pressure, eight of whom died. Fourteen were monitored due to suspected, but not detected, epilepsy, their underlying diagnoses being variable. Refractory status epilepticus was the reason for cEEG in 24 cases. All of these patients survived the acute phase of status epilepticus. Four patients had seizure activity on cEEG due to global anoxia; these were not classified as status epilepticus. In conclusion, in the paediatric intensive care unit the most important indication for cEEG monitoring is in patients with suspected refractory status epilepticus where it adds to the diagnosis and choice of treatment. Continuous EEG should therefore be part of the paediatric intensive care unit technical support to select and monitor, among children with critical neurological disorders, those with refractory status epilepticus.
Hyllienmark
Lars
L
Department of Neurology, Karolinska University Hospital, SE-17176 Stockholm, Sweden. lars.hyllienmark@karolinska.se
Amark
Per
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic; D009422:Nervous System Diseases / Q000451:nursing / Q000503:physiopathology; D012640:Seizures / Q000175:diagnosis / Q000503:physiopathology