title: The impact of amplitude-integrated electroencephalography on NICU practice.
abstract: OBJECTIVE
  To examine how the introduction of amplitude-integrated electroencephalography (aEEG) to our neonatal intensive care unit (NICU) influenced clinical practice.
  
  
  METHODS
  This was a retrospective study examining clinical practice three years before and three years after the introduction of aEEG monitors to our NICU. A time series analysis was performed to explore whether aEEG introduction was associated with changes in the rates of conventional EEGs performed, neurology consultations and neonates diagnosed with seizures.
  
  
  RESULTS
  Following aEEG introduction, the total number of conventional EEGs performed remained constant; however, there was significant shift in conventional EEG utilization towards neonates receiving fewer multiple EEGs and more single EEGs. There was no change in the rate of neurology consultations or the number of neonates diagnosed with seizures.
  
  
  CONCLUSIONS
  Introduction of aEEG monitors to our NICU has led to less reliance on conventional EEG as a tool for the serial evaluation of brain function. Since the number of neonates diagnosed with seizures did not increase, aEEG monitoring did not appear to uncover a significant subgroup of patients with subclinical seizures that would previously have gone undetected. Conventional EEG and aEEG are complementary tools for the assessment of newborn cerebral function.
authors.affiliation: Division of Neurology, The Hospital for Sick Children Research Institute and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Appendino
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McNamara
authors.forename: Matthew
authors.initials: M
authors.lastname: Keyzers
authors.forename: Derek
authors.initials: D
authors.lastname: Stephens
authors.forename: Cecil D
authors.initials: CD
authors.lastname: Hahn
mesh_terms: D000704:Analysis of Variance; D058256:Brain Waves / Q000502:physiology*; D018672:Community Health Planning; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008137:Longitudinal Studies; D008297:Male; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis*; D013997:Time Factors