Intravenous infusion device artifact in the EEG-confusion in the diagnosis of electrocerebral silence

Intravenous infusion devices are routinely used in the intensive care unit to accurately regulate the delivery of various intravenous fluids and vasoactive drugs. These devices have been well described in the literature as the cause of various electrocardiographic artifacts. There has been little documentation in the literature implicating these devices as the etiology of artifacts in the electroencephalogram. The association of intravenous infusion devices with electroencephalographic artifacts became relevant during the brain death evaluation of two patients. The electroencephalograms, which were done for documentation of electrocerebral silence clearly showed activity in both patients which disappeared when the intravenous infusion devices were stopped. Possible mechanisms responsible for producing these artifacts include piezoelectric current, poor electrode contact, inadequate skin preparation, current leakage, static charges and electromagnetic activity. In the evaluation of patients for electrocerebral silence, it is important to both recognize and eliminate this artifact so that it is not confused with true electrocerebral activity.