title: The use and yield of continuous EEG in critically ill patients: A comparative study of three centers.
abstract: OBJECTIVE
  Continuous EEG (cEEG) monitoring of critically ill patients has gained widespread use, but there is substantial reported variability in its use. We analyzed cEEG and antiseizure drug (ASD) usage at three high volume centers.
  
  
  METHODS
  We utilized a multicenter cEEG database used daily as a clinical reporting tool in three tertiary care sites (Emory Hospital, Brigham and Women's Hospital and Yale - New Haven Hospital). We compared the cEEG usage patterns, seizure frequency, detection of rhythmic/periodic patterns (RPP), and ASD use between the sites.
  
  
  RESULTS
  5792 cEEG sessions were analyzed. Indication for cEEG monitoring and recording duration were similar between the sites. Seizures detection rate was nearly identical between the three sites, ranging between 12.3% and 13.6%. Median time to first seizure and detection rate of RPPs were similar. There were significant differences in doses of levetiracetam, valproic acid, and lacosamide used between the three sites.
  
  
  CONCLUSIONS
  There was remarkable uniformity in seizure detection rates within three high volume centers. In contrast, dose of ASD used frequently differed between the three sites.
  
  
  CONCLUSIONS
  These large volume data are in line with recent guidelines regarding cEEG use. Difference in ASD use suggests discrepancies in how cEEG results influence patient management.
authors.affiliation: Department of Neurology, Hôpital du Valais, Sion, Switzerland; Department of Clinical Neurosciences, CHUV and University of Lausanne, Lausanne, Switzerland; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA. Electronic address: Vincent.Alvarez@hopitalvs.ch.
authors.forename: Vincent
authors.initials: V
authors.lastname: Alvarez
authors.affiliation: Emory University Hospital, Atlanta, GA, USA.
authors.forename: Andres A
authors.initials: AA
authors.lastname: Rodriguez Ruiz
authors.affiliation: Mission Health System, Ashville, NC, USA.
authors.forename: Suzette
authors.initials: S
authors.lastname: LaRoche
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Hirsch
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Parres
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
authors.forename: Paula E
authors.initials: PE
authors.lastname: Voinescu
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA; Thomas Jefferson University Hospital, Philadelphia, PA, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Fernandez
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Ognen A
authors.initials: OA
authors.lastname: Petroff
authors.affiliation: Comprehensive Epilepsy Center, Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Nishi
authors.initials: N
authors.lastname: Rampal
authors.affiliation: Emory University Hospital, Atlanta, GA, USA.
authors.forename: Hiba Arif
authors.initials: HA
authors.lastname: Haider
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use; D003422:Critical Care / Q000592:standards / Q000706:statistics & numerical data; D004569:Electroencephalography / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012640:Seizures / Q000175:diagnosis* / Q000188:drug therapy; D012680:Sensitivity and Specificity
chemical_list: D000927:Anticonvulsants
keywords: Brain monitoring; Continuous EEG monitoring; Neurocritical care; Seizures