Background

Continuous electroencephalography (cEEG) is the gold standard for brain monitoring in PICU. Seizure detection rates range from 7-43% across published studies. This may be attributable to differences in indications, duration of monitoring and patient cohort. Given the finite availability of cEEG in Europe, routine EEG studies (rEEG) are more commonly utilised to answer seizure-related clinical questions in PICU.

Objectives

Aims and Objectives: To investigate the rate of seizure detection within PICU using available rEEG resources.

To examine how the indication for, duration of, and delays to access of EEG influence seizure detection rates.

To place our findings in the context of international published literature.

Methods

Methodology: A retrospective observational study in an Irish tertiary-level PICU. All consecutive EEGs carried out in the PICU over a 2.5 year period were included.

Results

Results: 196 EEGs were carried out in 108 patients. Fifty seven percent of patients were aged 12 months or younger. Seizures were recorded in 28% of EEGs and 17% of patients

Seizure detection was more common among patients with an established history of seizures (26.3% vs 11%) and for whom seizures were the primary reason for ICU admission (55% vs 23%).

Patients with seizures had a mortality rate of 17% compared with general ICU mortality rate of 4.5%. The presence of seizures did not affect duration of ICU stay

Conclusion

Conclusion: Levels of seizure detection were lower than many studies described in the literature. This shortfall may be attributable to the reduced duration of EEG, pointing to a need for greater EEG accessibility in our PICU.

Background

Continuous electroencephalography (cEEG) is the gold standard for brain monitoring in PICU. Seizure detection rates range from 7-43% across published studies. This may be attributable to differences in indications, duration of monitoring and patient cohort. Given the finite availability of cEEG in Europe, routine EEG studies (rEEG) are more commonly utilised to answer seizure-related clinical questions in PICU.

Objectives

Aims and Objectives: To investigate the rate of seizure detection within PICU using available rEEG resources.

To examine how the indication for, duration of, and delays to access of EEG influence seizure detection rates.

To place our findings in the context of international published literature.

Methods

Methodology: A retrospective observational study in an Irish tertiary-level PICU. All consecutive EEGs carried out in the PICU over a 2.5 year period were included.

Results

Results: 196 EEGs were carried out in 108 patients. Fifty seven percent of patients were aged 12 months or younger. Seizures were recorded in 28% of EEGs and 17% of patients

Seizure detection was more common among patients with an established history of seizures (26.3% vs 11%) and for whom seizures were the primary reason for ICU admission (55% vs 23%).

Patients with seizures had a mortality rate of 17% compared with general ICU mortality rate of 4.5%. The presence of seizures did not affect duration of ICU stay

Conclusion

Conclusion: Levels of seizure detection were lower than many studies described in the literature. This shortfall may be attributable to the reduced duration of EEG, pointing to a need for greater EEG accessibility in our PICU.