Cerebral function monitoring on a general paediatric ward: feasibility and potential.
Cerebral function monitoring is widely used in neonatal intensive care, but its potential role in assessment of older infants is scarcely reported. We reviewed the use of cerebral function monitoring on a general paediatric ward in a series of young infants admitted with abnormal movements. Review of the amplitude-integrated EEG obtained by cerebral function monitoring revealed electrographic seizures in four of seven infants monitored. We also surveyed general paediatric wards in hospitals in our region of the UK to ask about current use of cerebral function monitoring and local availability of formal electroencephalography services. Cerebral function monitoring was not being used in the 16 other paediatric departments surveyed, and there was very limited provision for obtaining a full-array electroencephalogram out-of-hours.


CONCLUSIONS
With adequate training and education, it is feasible to undertake cerebral function monitoring on a general paediatric ward. Continuous cerebral function monitoring is a tool that has potential use for detecting clinical seizures and augmenting clinical neuro-observations of young children admitted to a general paediatric ward.


BACKGROUND
• In intensive care settings, cerebral function monitoring (CFM) has long been used for the continuous bedside monitoring of brain function in critically ill neonates, children and adults. • Very few studies have looked at the use of CFM outside of the intensive care setting, and it is presently unclear if CFM is used in the general paediatric ward. What is new: • CFM is presently not widely used in the general paediatric setting. • With appropriate training and support, CFM can be successfully introduced to the general paediatric ward with the potential to enhance the clinical monitoring of young infants admitted with abnormal movements.
Department of Paediatrics, Jenny Lind Children's Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, NR4 7UY, UK.
Vivek
V
Kalra
Department of Paediatrics, Jenny Lind Children's Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, NR4 7UY, UK.
Shahul Sikkander
SS
Shaw
Neonatal Intensive Care Unit, Jenny Lind Children's Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, NR4 7UY, UK.
Stacey
S
Dixon
Neonatal Intensive Care Unit, Royal London Hospital, London, E1 1BB, UK.|Barts and the London Medical School, London, UK.
Divyen K
DK
Shah
Neonatal Intensive Care Unit, Jenny Lind Children's Hospital, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, NR4 7UY, UK. paul.clarke@nnuh.nhs.uk.
Paul
P
Clarke
D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006748:Hospital Departments / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010372:Pediatrics / Q000379:methods; D012640:Seizures / Q000175:diagnosis*; D011795:Surveys and Questionnaires
Electroencephalography; Infant; Neurological; Neurophysiology; Seizure