北美地区定量脑电图应用范围：一项横断面调查

The Spectrum of Quantitative EEG Utilization Across North America: A Cross-Sectional Survey.

作者信息

Benedetti Giulia M, Morgan Lindsey A, Sansevere Arnold J, Harrar Dana B, Guerriero Réjean M, Wainwright Mark S, LaRovere Kerri L, Kielian Agnieszka, Ganesan Saptharishi Lalgudi, Press Craig A

机构信息

Division of Pediatric Neurology, Department of Neurology, University of Washington School of Medicine, Seattle, Washington.

Department of Neurology, Children's National Hospital and Departments of Neurology and Pediatrics, George Washington University School of Medicine, Washington, District of Columbia.

出版信息

Pediatr Neurol. 2023 Apr;141:1-8. doi: 10.1016/j.pediatrneurol.2022.12.016. Epub 2023 Jan 6.

DOI:10.1016/j.pediatrneurol.2022.12.016

PMID:36731228

Abstract

BACKGROUND

Continuous electroencephalography (cEEG) is commonly used for neuromonitoring in pediatric intensive care units (PICU); however, there are barriers to real-time interpretation of EEG data. Quantitative EEG (qEEG) transforms the EEG signal into time-compressed graphs, which can be displayed at the bedside. A survey was designed to understand current PICU qEEG use.

METHODS

An electronic survey was sent to the Pediatric Neurocritical Care Research Group and Pediatric Status Epilepticus Research Group, and intensivists in 16 Canadian PICUs. Questions addressed demographics, qEEG acquisition and storage, clinical use, and education.

RESULTS

Fifty respondents from 39 institutions completed the survey (response rate 53% [39 of 74 institutions]), 76% (37 of 50) from the United States and 24% (12 of 50) from Canada. Over half of the institutions (22 of 39 [56%]) utilize qEEG in their ICUs. qEEG use was associated with having a neurocritical care (NCC) service, ≥200 NCC consults/year, ≥1500 ICU admissions/year, and ≥4 ICU EEGs/day (P < 0.05 for all). Nearly all users (92% [24 of 26]) endorsed that qEEG enhanced care of children with acute neurological injury. Lack of training in qEEG was identified as a common barrier [85% (22 of 26)]. Reviewing and reporting of qEEG was not standard at most institutions. Training was required by 14% (three of 22) of institutions, and 32% (seven of 22) had established curricula.

CONCLUSIONS

ICU qEEG was used at more than half of the institutions surveyed, but review, reporting, and application of this tool remained highly variable. Although providers identify qEEG as a useful tool in patient management, further studies are needed to define clinically meaningful pediatric trends, standardize reporting, and enhance educate bedside providers.

摘要

背景

连续脑电图（cEEG）常用于儿科重症监护病房（PICU）的神经监测；然而，脑电图数据的实时解读存在障碍。定量脑电图（qEEG）将脑电图信号转换为时间压缩图，可在床边显示。设计了一项调查以了解当前PICU中qEEG的使用情况。

方法

向儿科神经重症监护研究组、小儿癫痫持续状态研究组以及加拿大16个PICU的重症监护医生发送了电子调查问卷。问题涉及人口统计学、qEEG采集与存储、临床应用及教育情况。

结果

来自39个机构的50名受访者完成了调查（回复率53%[74个机构中的39个]），其中76%（50人中的37人）来自美国，24%（50人中的12人）来自加拿大。超过一半的机构（39个中的22个[56%]）在其ICU中使用qEEG。qEEG的使用与拥有神经重症监护（NCC）服务、每年≥200次NCC会诊、每年≥1500例ICU入院以及每天≥4次ICU脑电图检查相关（所有P均<0.05）。几乎所有用户（92%[26人中的24人]）认可qEEG改善了急性神经损伤儿童的护理。qEEG培训不足被视为一个常见障碍[85%（26人中的22人）]。大多数机构对qEEG的审查和报告并不规范。14%（22个机构中的3个）的机构要求进行培训，32%（22个机构中的7个）已制定课程。