Continuous EEG monitoring in the ICU: challenges and opportunities

Continuous EEG monitoring (CEEG) in the ICU is increasingly recognized as valuable means of monitoring cerebral function, otherwise inaccessible in the comatose patient. The principal applications are: monitoring for seizures and ischemia, guiding therapy for seizures and ischemia (especially vasospasm), adjusting levels of sedation for paralyzed or delirious patients, charting trends in brain function and prognosis. Continuous EEG monitoring is faced with numerous challenges: electrode failures (better electrodes are needed to replace standard EEG electrodes), documentation in the absence of a technologist, artifacts peculiar to ICU, prompt interpretation and review of large amounts of data, resource allocation and establishing the technology as being useful in improving outcomes and shortening ICU and hospital length of stay.