Conductive Plastic Electrodes Reduce EEG Artifact During Pediatric ECMO Therapy

Area of Science:

• Neuroscience
• Biomedical Engineering
• Critical Care Medicine

Background:

• Continuous electroencephalogram (EEG) monitoring is crucial for detecting neurologic complications in pediatric patients on extracorporeal membrane oxygenation (ECMO).
• ECMO therapy, a life-saving heart-lung bypass, frequently introduces significant EEG artifact, complicating neuromonitoring.
• Factors like sedation and hemodynamic instability further challenge clinical and radiographic evaluations in ECMO patients.

Purpose of the Study:

• To evaluate whether conductive plastic electrodes reduce EEG artifact compared to conventional gold electrodes in pediatric ECMO patients.
• To assess the impact of electrode type on the interpretability and confidence of EEG readings during ECMO.

Main Methods:

• EEG samples from 21 pediatric ECMO patients were assessed by masked electroencephalographers for artifact and interpretability (14 gold, 7 plastic electrodes).
• Spectral power analysis quantified 50- to 70-Hz artifact in a larger cohort (14 gold, 34 plastic electrodes during ECMO; 4 non-ECMO gold controls).

Main Results:

• Plastic electrodes were associated with significantly less EEG artifact and greater confidence in interpretation (P < 0.001).
• Quantitative analysis revealed higher 50- to 70-Hz power with gold electrodes during ECMO compared to plastic electrodes (P < 0.001).
• Artifact significantly compromised EEG interpretation in studies using gold electrodes more frequently than plastic electrodes.

Conclusions:

• Conductive plastic electrodes substantially decrease electrical artifact burden in pediatric ECMO EEG studies.
• The use of plastic electrodes enhances confidence in EEG interpretation for critically ill pediatric patients on ECMO.