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Intensive Care Medicine

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01-08-2013 | Systematic Review

Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM

Authors: Jan Claassen, Fabio S. Taccone, Peter Horn, Martin Holtkamp, Nino Stocchetti, Mauro Oddo

Published in: Intensive Care Medicine | Issue 8/2013

Abstract

Objectives

Recommendations for EEG monitoring in the ICU are lacking. The Neurointensive Care Section of the ESICM assembled a multidisciplinary group to establish consensus recommendations on the use of EEG in the ICU.

Methods

A systematic review was performed and 42 studies were included. Data were extracted using the PICO approach, including: (a) population, i.e. ICU patients with at least one of the following: traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage, stroke, coma after cardiac arrest, septic and metabolic encephalopathy, encephalitis, and status epilepticus; (b) intervention, i.e. EEG monitoring of at least 30 min duration; (c) control, i.e. intermittent vs. continuous EEG, as no studies compared patients with a specific clinical condition, with and without EEG monitoring; (d) outcome endpoints, i.e. seizure detection, ischemia detection, and prognostication. After selection, evidence was classified and recommendations developed using the GRADE system.

Recommendations

The panel recommends EEG in generalized convulsive status epilepticus and to rule out nonconvulsive seizures in brain-injured patients and in comatose ICU patients without primary brain injury who have unexplained and persistent altered consciousness. We suggest EEG to detect ischemia in comatose patients with subarachnoid hemorrhage and to improve prognostication of coma after cardiac arrest. We recommend continuous over intermittent EEG for refractory status epilepticus and suggest it for patients with status epilepticus and suspected ongoing seizures and for comatose patients with unexplained and persistent altered consciousness.

Conclusions

EEG monitoring is an important diagnostic tool for specific indications. Further data are necessary to understand its potential for ischemia assessment and coma prognostication.

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Title: Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM
Authors: Jan Claassen
Fabio S. Taccone
Peter Horn
Martin Holtkamp
Nino Stocchetti
Mauro Oddo
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 8/2013
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-013-2938-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM

Abstract

Objectives

Methods

Recommendations

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Recommendations

Conclusions

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Other articles of this Issue 8/2013

Neurally adjusted ventilatory assist: letting the respiratory center take over control of ventilation

Half-molar sodium lactate infusion to prevent intracranial hypertensive episodes in severe traumatic brain injured patients: a randomized controlled trial

Erratum to: Effect of different seated positions on lung volume and oxygenation in acute respiratory distress syndrome

Precautions with heated humidifier systems in particular environments

It’s getting better all the time? Using secular trends to understand the impact of neurocritical care

Diastolic dysfunction and N-terminal pro-brain natriuretic peptide in children with meningococcal sepsis