Lauren Koffman1, Fred Rincon2, Joao Gomes3, Sarabdeep Singh4, Yitian He5, Eva Ritzl6, Thomas P Bleck1, Peter W Kaplan7, Paul Nyquist8. 1. Department of Neurological Sciences, 2468Rush University Medical Center, Chicago, IL, USA. 2. Cerebrovascular Disease and Neurocritical Care, Thomas Jefferson University, Philadelphia, PA, USA. 3. Cerebrovascular Center, 2569Cleveland Clinic, Cleveland, OH, USA. 4. Department of Core Clinical Research and Biostatistics, 1500Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. 5229University of Wisconsin-Madison, Madison, WI, USA. 6. Department of Neurology and Epilepsy, 1466The Johns Hopkins Hospital, Baltimore, MD, USA. 7. Department of Neurology and Epilepsy, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA. 8. Department of Anesthesiology and Critical Care Medicine, 1466The Johns Hopkins Hospital, Baltimore, MD, USA.
Abstract
OBJECTIVE: Research on continuous electro-encephalographic monitoring (cEEG) in the intensive care unit (ICU) has previously focused on neuroscience ICUs. This study determines cEEG utilization within a sample of specialty ICUs world-wide. METHODS: A cross-sectional electronic survey of attending level physicians across various intensive care settings. Twenty-five questions developed from consensus statements on the use of cEEG in the critically ill sent as an electronic survey. RESULTS: Of all, 9344 were queried and 417 (4.5%) responses were analyzed with 309 (74%) from the United States and 74 (18%) internationally. Intensive care units were: medical (10%), surgical (6%), neurologic/neurosurgical (12%), cardiac (4%), trauma (3%), pediatrics (29%), burn (<1%), multidisciplinary (30%), and other (5%). Intensive care units were: academic (65%), community (18%), public (3%), military (1%), and other (13%). Specialized cEEG teams were available in 71% of ICUs. Rapid 24/7 access and cEEG interpretation was available in 32% of ICUs. Interpretation changed clinical management frequently (28%) and sometimes (45%). CONCLUSIONS: Despite guideline recommendations for cEEG use, there is a discordance between availability, night coverage, and immediate interpretation. Only 27% have institutional protocols for indications and duration of cEEG monitoring. Furthermore, cEEG may be underutilized in nonneurologic ICUs as well as ICUs in smaller nonacademic affiliated hospitals and those outside of the United States.
OBJECTIVE: Research on continuous electro-encephalographic monitoring (cEEG) in the intensive care unit (ICU) has previously focused on neuroscience ICUs. This study determines cEEG utilization within a sample of specialty ICUs world-wide. METHODS: A cross-sectional electronic survey of attending level physicians across various intensive care settings. Twenty-five questions developed from consensus statements on the use of cEEG in the critically ill sent as an electronic survey. RESULTS: Of all, 9344 were queried and 417 (4.5%) responses were analyzed with 309 (74%) from the United States and 74 (18%) internationally. Intensive care units were: medical (10%), surgical (6%), neurologic/neurosurgical (12%), cardiac (4%), trauma (3%), pediatrics (29%), burn (<1%), multidisciplinary (30%), and other (5%). Intensive care units were: academic (65%), community (18%), public (3%), military (1%), and other (13%). Specialized cEEG teams were available in 71% of ICUs. Rapid 24/7 access and cEEG interpretation was available in 32% of ICUs. Interpretation changed clinical management frequently (28%) and sometimes (45%). CONCLUSIONS: Despite guideline recommendations for cEEG use, there is a discordance between availability, night coverage, and immediate interpretation. Only 27% have institutional protocols for indications and duration of cEEG monitoring. Furthermore, cEEG may be underutilized in nonneurologic ICUs as well as ICUs in smaller nonacademic affiliated hospitals and those outside of the United States.
Authors: Brenda G Fahy; Samsun Lampotang; Jean E Cibula; W Travis Johnson; Lou Ann Cooper; David Lizdas; Nikolaus Gravenstein; Terrie Vasilopoulos Journal: Cureus Date: 2022-04-24
Authors: Michael C Jin; Jonathon J Parker; Michael Zhang; Zack A Medress; Casey H Halpern; Gordon Li; John K Ratliff; Gerald A Grant; Robert S Fisher; Stephen Skirboll Journal: J Neurosurg Date: 2021-05-14 Impact factor: 5.115