Author Of 1 Presentation
THE ROLE OF CONTINUOUS EEG MONITORING IN CHILDREN ADMITTED TO A CARDIAC INTENSIVE CARE UNIT Â
Abstract
Background
Patients on extracorporeal membrane oxygenation (ECMO) or following cardiac surgery are at a high risk of neurological complications, including intracranial haemorrhage, stroke and seizures and, therefore, at risk of future neurodisability. EEG is often utilised as a neuromonitoring tool in the Cardiac Intensive Care Unit (CICU) as children are sedated and muscle relaxed. However, continuous electroencephalogram (EEG) is not employed routinely.
Objectives
We evaluated our practice with the aim to reach a consensus in duration of EEG monitoring.
Methods
All patients who received EEG monitoring on CICU while on ECMO or following cardiac surgery from 01/11/2017 until 31/10/2018 were included. Data was collected retrospectively from patients’ clinical notes and the Clinical Neurophysiology database.
Results
Sixty-four patients were identified: 29(45%) on ECMO and 35(55%) post-op. Median age was 7 months (1 day-15 years). Out of the 120 EEG recordings, the majority (n=101, 84%) were less than an hour in duration, and 19 (16%) were prolonged ranging from 2 to 72 hours. Seven had seizures detected on EEG with or without clinical signs (3 electrographic and 4 electro-clinical) and 5 were detected during prolonged EEG recordings. Antiepileptic drugs were administered in 9 children following strong clinical suspicion. None of the subsequent recordings detected seizure activity.
Conclusion
This small study highlights the importance of a standardised approach to prolonged or continuous EEG monitoring for certain high-risk patient groups. Not only does it lead to seizure detection but also strengthens the assessment of neurological status and detection of potential asymmetries prompting appropriate neuro-imaging.
Presentation files
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ESPNIC cEEG on CICU 19th June 19.06.2019 15:20
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ESPNIC cEEG on CICU 15.06.2019 20:25