Application of amplitude-integrated EEG in neurocritical care

Abstract

The need for continuous electroencephalograms (cEEGs) monitoring is increasing in neurocritical care; however, cEEG monitoring requires experienced specialists for application and interpretation. Amplitude-integrated EEGs (aEEGs), generated from simplified EEG montage, with a limited number of raw EEG curves, are notably easy to read and has been widely used in neonatal hypoxic ischemic encephalopathy for prognostication. Recently they are also applied for adult patients with post cardiac arrest syndrome (PCAS), especially those under therapeutic hypothermia treatment. We applied aEEG to monitor 59 critically ill neurological patients, including 31 PCAS, 14 subarachnoid hemorrhage (SAH), 4 intracerebral hemorrhage, 3 convulsion, etc., with 31 of them under therapeutic hypothermia. Initial aEEG patterns were: continuous, 18: discontinuous, 14: electrographic status epilepticus (ESE), 7: suppression burst (SB), 7: flat, 9: and artifacts, 4. PCAS patients showing continuous pattern had generally good functional recovery, while SB and flat pattern indicated poor outcome. Real-time monitoring with aEEGs was feasible in various kinds of critical neurological illness and provided useful information for prognostication and administration of antiepileptics.