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

Giulia M. Benedetti, Division of Pediatric Neurology, Department of Neurology, University of Washington School of Medicine, Seattle, Washington.
Lindsey A. Morgan, Division of Pediatric Neurology, Department of Neurology, University of Washington School of Medicine, Seattle, Washington.
Arnold J. Sansevere, Department of Neurology, Children's National Hospital and Departments of Neurology and Pediatrics, George Washington University School of Medicine, Washington, District of Columbia.
Dana B. Harrar, Department of Neurology, Children's National Hospital and Departments of Neurology and Pediatrics, George Washington University School of Medicine, Washington, District of Columbia.
Réjean M. Guerriero, Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
Mark S. Wainwright, Division of Pediatric Neurology, Department of Neurology, University of Washington School of Medicine, Seattle, Washington.
Kerri L. LaRovere, Department of Neurology, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts.
Agnieszka Kielian, Department of Neurology, Harvard Medical School and Boston Children's Hospital, Boston, Massachusetts.
Saptharishi Lalgudi Ganesan, Paediatric Critical Care Medicine, Children's Hospital of Western Ontario, London Health Sciences Centre, London, Ontario, Canada; Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Craig A. Press, Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Document Type

Journal Article

Publication Date

1-6-2023

Journal

Pediatric neurology

Volume

141

DOI

10.1016/j.pediatrneurol.2022.12.016

Keywords

Continuous EEG; Critical care; Neuromonitoring; Pediatric neurocritical care; Quantitative EEG; Seizure; Spectral analysis

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.

Department

Neurology

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