title: Need for quality control for aEEG monitoring of the preterm infant: a 2-year experience.
abstract: OBJECTIVE
  To establish and apply a questionnaire for the evaluation of amplitude-integrated electroencephalogram (aEEG) with respect to practicability and feasibility in the NICU, to reveal strategies for improvements in daily use and to investigate the level of staff know-how with regard to performance and evaluation of bedside aEEG for the purpose of quality control.
  
  
  METHODS
  Amplitude-integrated electroencephalogram was routinely applied in preterm infants below 32 weeks of gestational age for a period of 2 years. Practicability, feasibility and the level of know-how with regard to aEEG were assessed using a multiple-choice questionnaire.
  
  
  RESULTS
  Major problems in the use of aEEG in preterm infants were identified as time needed for placement and frequent readjustment of electrodes. Quality control showed the following problems: seizure activity was correctly diagnosed in 60.0%, discontinuous (DC) background in 45.5% and burst suppression (BS) in 41.8% of patients. Overall, BS and DC were the patterns most frequently interpreted incorrectly.
  
  
  CONCLUSIONS
  Amplitude-integrated electroencephalogram is frequently used in neonatology. In preterm infants with several challenges, repeated theoretical and practical trainings as well as quality control are needed in order for aEEG to become a routinely used monitoring instrument in daily preterm care.
authors.affiliation: Department of Paediatrics IV, Division of Neonatology, Neuropaediatrics and Metabolic Disorders, Innsbruck Medical University, Innsbruck, Austria. elke.griesmaier@i-med.ac.at
authors.forename: Elke
authors.initials: E
authors.lastname: Griesmaier
authors.forename: Vera
authors.initials: V
authors.lastname: Neubauer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ralser
authors.forename: Rudolf
authors.initials: R
authors.lastname: Trawöger
authors.forename: Ursula
authors.initials: U
authors.lastname: Kiechl-Kohlendorfer
authors.forename: Matthias
authors.initials: M
authors.lastname: Keller
mesh_terms: D004502:Education, Medical, Continuing; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis*; D007363:Intensive Care Units, Neonatal; D008505:Medical Staff, Hospital; D008991:Monitoring, Physiologic; D009359:Neonatology / Q000193:education; D009741:Nursing Staff, Hospital; D011785:Quality Assurance, Health Care; D012640:Seizures / Q000175:diagnosis