Abstracts

Rationale: 1) To investigate the feasibility and safety of conductive plastic electrodes (CPEs, Ives EEG Solutions, Ontario, Canada) in patients undergoing continuous video-electroencephalographic (EEG) monitoring and 2) to assess the quality of brain MRI and cranial CT imaging obtained during such monitoring Methods: We evaluated consecutive ICU patients between January 1 1 and May 15, 2008, who were monitored, using CPEs. Results: A total of 24 patients were monitored. Indications for EEG monitoring in these patients included vascular causes of altered mental status, including strokes and hemorrhages (11 patients), uncontrolled seizures (6), brain tumors (3), cerebral infections including encephalitis (3) and metabolic encephalopathy (1). Impedance did not differ from standard gold cup leads. A total of 12 brain MRIs and 11 head CTs were performed on 14 patients. One patient had three MRIs, 2 had multiple CTs and 4 had both MRIs and CT scans. Six scans were obtained beyond normal working hours. All patients had good quality anatomical images without artifact, and without any signs or symptoms that raised safety concerns. CPEs provided interpretable and relevant EEG recordings for patients in the ICU. Seizures were recorded in 8/24 patients. Conclusions: In this study we investigated the use and safety of CPE electrodes in ICU EEG monitoring. These CT and MRI compatible electrodes produced no significant radiographic artifacts. Recording quality of the EEG was comparable to standard gold electrodes. The use of CPE electrodes allowed for noninterruptible EEG recording and facilitated emergent neuroimaging, particularly off hours, as EEG electrodes did not need to be removed.