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Continuous Electroencephalography Monitoring for Critically Ill Neonates: A Canadian Perspective

Title: Continuous Electroencephalography Monitoring for Critically Ill Neonates: A Canadian Perspective
Authors: Buttle, Sarah Grace; Sell, Erick; Webster, Richard; Varin, Melanie; Lemyre, Brigitte; Hahn, Cecil; Pohl, Daniela
Source: Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ; volume 46, issue 04, page 394-402 ; ISSN 0317-1671 2057-0155
Publisher Information: Cambridge University Press (CUP)
Publication Year: 2019
Description: Background: Continuous EEG monitoring, in the form of amplitude-integrated (aEEG) or conventional EEG (cEEG), is used in the neonatal intensive care unit (NICU) to detect subclinical central nervous system pathologies, inform management, and prognosticate neurodevelopmental outcomes. To learn more about provider attitudes and current practices in Canada, we evaluated neurologist and neonatologist opinions regarding NICU EEG monitoring. Methods: A 15-item electronic questionnaire was distributed to 114 pediatric neurologists and 176 neonatologists working across 25 sites. Results: The survey was completed by 87 of 290 physicians. Continuous EEG monitoring is utilized by 97% of pediatric neurologists and 92% of neonatologists. Neurologists and neonatologists differ in their EEG monitoring preferences. For seizure detection and diagnosis of encephalopathy, significantly more neonatologists favor aEEG alone or in combination with cEEG, whereas most neurologists prefer cEEG ( p = 0.047, 0.001). There is a significant difference in the perceived gaps in monitoring patients with cEEG between neonatologists (13% would monitor more) and neurologists (41% would monitor more) ( p = 0.007). Half of all respondents (53%) reported that they would be interested in attending an education session on neonatal EEG monitoring. Conclusions: Canadian neurologists and neonatologists do not agree on the best monitoring approach for critically ill neonates. Furthermore, neonatologists perceive a smaller cEEG monitoring gap as compared with neurologists. However, many participants from both specialties would like to increase long-term EEG monitoring in the NICU setting. Facilitating access to EEG monitoring and enhancing education may help to address these needs.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1017/cjn.2019.36
Availability: https://doi.org/10.1017/cjn.2019.36; https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0317167119000362
Rights: https://www.cambridge.org/core/terms
Accession Number: edsbas.7BA1910B
Database: BASE