Division of Neurology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, PA 19104, USA.
Neurocrit Care. 2011 Aug;15(1):70-5. doi: 10.1007/s12028-010-9380-z.
Continuous EEG (cEEG) monitoring is being used with increasing frequency in critically ill patients, most often to detect non-convulsive seizures. While cEEG is non-invasive and feasible in the critical care setting, it is also expensive and labor intensive, and there has been little study of its impact on clinical care. We aimed to determine prospectively the impact of cEEG on clinical management in critically ill children.
Critically ill children (non-neonates) with acute encephalopathy underwent cEEG. Study enrollment and data collection were prospective.
100 children were studied. EEG monitoring led to specific clinical management changes in 59 children. These included initiating or escalating anti-seizure medications in 43 due to seizure detection, demonstrating that a specific event (subtle movement or vital sign change) was not a seizure in 21, or obtaining urgent neuroimaging that led to a clinical change in 3. In the remaining 41 children, cEEG ruled out the presence of non-convulsive seizures but did not lead to a specific change in clinical management.
EEG monitoring led to changes in clinical management in the majority of patients, suggesting it may have an important role in management of critically ill children. Further study is needed to determine whether the management changes elicited by cEEG improve outcome.
连续脑电图（cEEG）监测在危重病患者中越来越频繁地使用，主要用于检测非惊厥性发作。虽然 cEEG 在重症监护环境中是无创且可行的，但它也很昂贵且劳动强度大，而且对其对临床护理的影响的研究很少。我们旨在前瞻性地确定 cEEG 对危重病儿童临床管理的影响。
急性脑病的危重病儿童（非新生儿）接受 cEEG 监测。研究的入组和数据收集是前瞻性的。
共研究了 100 名儿童。脑电图监测导致 59 名儿童的具体临床管理发生变化。其中 43 例因检测到癫痫发作而开始或升级抗癫痫药物，21 例证明特定事件（细微运动或生命体征变化）不是癫痫发作，3 例获得紧急神经影像学检查，导致临床变化。在其余 41 名儿童中，cEEG 排除了非惊厥性发作的存在，但没有导致临床管理的具体变化。
脑电图监测导致大多数患者的临床管理发生变化，这表明它可能在危重病儿童的管理中发挥重要作用。需要进一步研究以确定 cEEG 引起的管理变化是否改善预后。
