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The Impact of Amplitude-Integrated Electroencephalography on NICU Practice

Published online by Cambridge University Press:  02 December 2014

Juan Pablo Appendino ,
Patrick J. McNamara ,
Matthew Keyzers ,
Derek Stephens  and
Cecil D. Hahn
Juan Pablo Appendino
Affiliation:
Division of Neurology, The Hospital for Sick Children Research Institute and University of Toronto, Toronto, Ontario Division of Neurology, Children's Hospital of Winnipeg and the University of Manitoba, Winnipeg, Manitoba, Canada
Patrick J. McNamara
Affiliation:
Division of Neonatology, The Hospital for Sick Children Research Institute and University of Toronto, Toronto, Ontario
Matthew Keyzers
Affiliation:
Division of Neonatology, The Hospital for Sick Children Research Institute and University of Toronto, Toronto, Ontario
Derek Stephens
Affiliation:
Clinical Research Support Unit, The Hospital for Sick Children Research Institute and University of Toronto, Toronto, Ontario
Cecil D. Hahn*
Affiliation:
Division of Neurology, The Hospital for Sick Children Research Institute and University of Toronto, Toronto, Ontario
*
Division of Neurology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada. Email: [email protected]
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Abstract

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Objective:

To examine how the introduction of amplitude-integrated electroencephalography (aEEG) to our neonatal intensive care unit (NICU) influenced clinical practice.

Methods:

This was a retrospective study examining clinical practice three years before and three years after the introduction of aEEG monitors to our NICU. A time series analysis was performed to explore whether aEEG introduction was associated with changes in the rates of conventional EEGs performed, neurology consultations and neonates diagnosed with seizures.

Results:

Following aEEG introduction, the total number of conventional EEGs performed remained constant; however, there was significant shift in conventional EEG utilization towards neonates receiving fewer multiple EEGs and more single EEGs. There was no change in the rate of neurology consultations or the number of neonates diagnosed with seizures.

Conclusions:

Introduction of aEEG monitors to our NICU has led to less reliance on conventional EEG as a tool for the serial evaluation of brain function. Since the number of neonates diagnosed with seizures did not increase, aEEG monitoring did not appear to uncover a significant subgroup of patients with subclinical seizures that would previously have gone undetected. Conventional EEG and aEEG are complementary tools for the assessment of newborn cerebral function.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 3 , May 2012 , pp. 355 - 360
Copyright
Copyright © The Canadian Journal of Neurological 2012

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