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Consensus statement on continuous EEG in critically ill adults and children, part I: indications
Susan T Herman1, Nicholas S Abend, Thomas P Bleck
1*Comprehensive Epilepsy Program, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, U.S.A.; †Departments of Neurology and Pediatrics, Perelman School of Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.; ‡Departments of Neurological Sciences, Neurosurgery, Medicine, and Anesthesiology, Rush Medical College, Chicago, Illinois, U.S.A.; §Department of Pediatrics and Neurology, University of Colorado, Boulder, Colorado, U.S.A.; ‖Department of Neurology, Hospital for Special Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, New York, U.S.A.; ¶Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, U.S.A. #Division of Neurology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; **Department of Neurology, Duke University Medical Center, Durham, North Carolina, U.S.A.; ††Neurodiagnostic Center, Veterans Affairs Medical Center, Durham, North Carolina, U.S.A.; ‡‡Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, U.S.A.; §§Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.; ‖‖Department of Neurology, David Geffen School of Medicine and Clinical Neurophysiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, U.S.A.; ¶¶FE Dreifuss Comprehensive Epilepsy Program, Department of Neurology, University of Virginia, Charlottesville, Virginia, U.S.A.; ##NYU Division of Child Neurology, Columbia University Medical Center, New York, New York, U.S.A.; ***Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.; †††School of Clinical Neurophysiology, Crozer-Chester Medical Center, Upland, Pennsylvania, U.S.A.; ‡‡‡Department of Neurology and Pediatrics, Children's National Med
Critical Care Continuous EEG (CCEEG) provides vital brain monitoring for critically ill patients. Expert consensus now guides its use for diagnosing seizures, assessing consciousness, and predicting outcomes in intensive care units.
Area of Science:
- Neuroscience
- Critical Care Medicine
- Clinical Neurophysiology
Background:
- Continuous EEG (CCEEG) is essential for monitoring brain function in intensive care unit (ICU) patients with altered mental status.
- Significant variability exists in CCEEG patient populations and technical performance standards.
Purpose of the Study:
- To establish expert consensus recommendations for the application of CCEEG in critically ill adults and children.
- To standardize CCEEG utilization in diverse intensive care settings.
Main Methods:
- Development of consensus recommendations by the Critical Care Continuous EEG Task Force of the American Clinical Neurophysiology Society.
- Review of evidence and expert opinion for various CCEEG indications.
Main Results:
- CCEEG is recommended for diagnosing nonconvulsive seizures, status epilepticus, and paroxysmal events.
- CCEEG is suggested for identifying cerebral ischemia, assessing consciousness under sedation/coma, and prognostication post-cardiac arrest.
- Detailed guidelines cover patient populations, evidence, utility of video/quantitative EEG, timing, duration, and interpretation frequency.
Conclusions:
- CCEEG plays a crucial role in detecting secondary brain injuries like seizures and ischemia in critically ill patients.
- Standardized CCEEG use improves patient management and outcomes in the ICU.
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