Reduced Continuous EEG Electrode Arrays in Critical Care Settings: A Narrative Review
Abstract number :
V.023
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2021
Submission ID :
1825705
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Xiuxian Pham, MBBS (Hons), BMedSci (Hons) - 1. Monash University, 2. Alfred Health; Joshua Laing, BBiomedSci (Hons), MBBS, FRACP - Consultant Neurologist and Epileptologist, Department of Neurology, Alfred Health; Patrick Kwan, BMedSci (Hons), MB BChir, PhD, FRACP - Director of Epilepsy, Department of Neurology, Alfred Health; Piero Perucca, MD, PhD, FRACP - Director of Epilepsy, Comprehensive Epilepsy Program, Austin Health; Terence O'Brien, MBBS, MD, FRACP, FRCPE, FAHMS, FAES - Program Director of Alfred Brain, Department of Neurology, Alfred Health; Andrew Udy, BHB, MB ChB, PGCert(AME), PhD, FCICM - Deputy Director, Australian and New Zealand Intensive Race - Research Centre, Monash University
Rationale: Non-convulsive status epilepticus is a neurological emergency that can be difficult to diagnose and treat without continuous electroencephalography (cEEG). However, there are several challenges in utilising cEEG in critical care settings. One means to improving access is streamlining electrode arrays by exploring the diagnostic accuracy of reduced arrays compared to the current standard 10-20 system. This review examines the current literature on reduced electrode array models in critical care settings.
Methods: A literature review was conducted searching three electronic databases (MEDLINE, Embase and CENTRAL) up to April 2020, as well as by citation chaining, for studies comparing reduced electrode arrays to the current 21 leads standard in adults in acute care settings.
Results: 1641 studies were identified, of which 13 studies were eligible and included in qualitative synthesis. Of these, 77% (10/13) were retrospective studies and 92.3% (12/13) were single-centred studies. Examined models ranged from using 4 to 12 leads, with variable setup strategies including hairline, forehead, circumferential and double interelectrode distance. Study objectives primarily revolved around seizure detection sensitivity and specificity with a reduced montage. While the objectives were largely similar across studies, the selection criteria and methodology varied substantially. Reduced array models demonstrated high specificity rates ranging from 86-100%, but varied significantly in sensitivity at 54-100% depending on the model and methodology. Overall, the majority of studies (12/13) favoured ongoing investigation and refinement of reduced electrode arrays given barriers in obtaining the standard setup in a timely and cost-effective manner for cEEG.
Conclusions: Compiled studies were heterogeneous in methodology and remains inconclusive as to the diagnostic strengths of reduced electrode arrays. One crucial aspect to consider for interpretation of current and future studies is the role of reduced electrode arrays in patient care in critical care settings, as this would determine the acceptable sensitivity and specificity threshold for seizures and NCSE detection. While there is theoretical value in pursuing efficiency to improve cEEG availability in critical care settings, further investigations are necessary to determine the optimal system.
Funding: Please list any funding that was received in support of this abstract.: Nil.
Neurophysiology