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儿科 ICU 脑电监测调查——十年后再评估。

Survey of Pediatric ICU EEG Monitoring-Reassessment After a Decade.

机构信息

Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, U.S.A.

Departments of Pediatrics and Neurology, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A.

出版信息

J Clin Neurophysiol. 2024 Jul 1;41(5):458-472. doi: 10.1097/WNP.0000000000001006. Epub 2023 Mar 16.

Abstract

PURPOSE

In 2011, the authors conducted a survey regarding continuous EEG (CEEG) utilization in critically ill children. In the interim decade, the literature has expanded, and guidelines and consensus statements have addressed CEEG utilization. Thus, the authors aimed to characterize current practice related to CEEG utilization in critically ill children.

METHODS

The authors conducted an online survey of pediatric neurologists from 50 US and 12 Canadian institutions in 2022.

RESULTS

The authors assessed responses from 48 of 62 (77%) surveyed institutions. Reported CEEG indications were consistent with consensus statement recommendations and included altered mental status after a seizure or status epilepticus, altered mental status of unknown etiology, or altered mental status with an acute primary neurological condition. Since the prior survey, there was a 3- to 4-fold increase in the number of patients undergoing CEEG per month and greater use of written pathways for ICU CEEG. However, variability in resources and workflow persisted, particularly regarding technologist availability, frequency of CEEG screening, communication approaches, and electrographic seizure management approaches.

CONCLUSIONS

Among the surveyed institutions, which included primarily large academic centers, CEEG use in pediatric intensive care units has increased with some practice standardization, but variability in resources and workflow were persistent.

摘要

目的

2011 年,作者就连续脑电监测(CEEG)在危重症儿童中的应用进行了一项调查。在这十年间,文献不断增加,指南和共识声明也涉及 CEEG 的应用。因此,作者旨在描述目前危重症儿童 CEEG 应用的相关实践情况。

方法

作者于 2022 年对 50 家美国和 12 家加拿大机构的儿科神经科医生进行了在线调查。

结果

作者评估了来自 62 家被调查机构中的 48 家(77%)的反馈。报告的 CEEG 指征与共识声明的建议一致,包括癫痫发作或癫痫持续状态后的意识改变、病因不明的意识改变,或伴有急性原发性神经系统疾病的意识改变。自上次调查以来,每月接受 CEEG 的患者数量增加了 3 至 4 倍,并且 ICU CEEG 的书面流程得到了更多的应用。然而,资源和工作流程的差异仍然存在,特别是在技术人员的可用性、CEEG 筛查的频率、沟通方法和电癫痫管理方法方面。

结论

在所调查的机构中,包括主要的大型学术中心,儿科重症监护病房中 CEEG 的使用有所增加,并且一些实践已经标准化,但资源和工作流程的差异仍然存在。

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Survey of Pediatric ICU EEG Monitoring-Reassessment After a Decade.儿科 ICU 脑电监测调查——十年后再评估。
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本文引用的文献

5
A Survey of Neuromonitoring Practices in North American Pediatric Intensive Care Units.北美儿科重症监护病房神经监测实践调查。
Pediatr Neurol. 2022 Jan;126:125-130. doi: 10.1016/j.pediatrneurol.2021.11.002. Epub 2021 Nov 12.
6
Spectrograms for Seizure Detection in Critically Ill Children.用于危重症儿童癫痫检测的声谱图。
J Clin Neurophysiol. 2022 Mar 1;39(3):195-206. doi: 10.1097/WNP.0000000000000868.
8
A Consensus-Based Checklist for Reporting of Survey Studies (CROSS).基于共识的调查研究报告清单(CROSS)
J Gen Intern Med. 2021 Oct;36(10):3179-3187. doi: 10.1007/s11606-021-06737-1. Epub 2021 Apr 22.

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