Subscribe to RSS
DOI: 10.1055/s-0034-1395483
Amplitude-Integrated Electroencephalography: A Survey of Practices in the United States
Publication History
26 August 2014
01 October 2014
Publication Date:
17 December 2014 (online)
![](https://www.thieme-connect.de/media/ajp/201508/lookinside/thumbnails/10-1055-s-0034-1395483_140279-1.jpg)
Abstract
Objective Amplitude-integrated electroencephalography (aEEG) is a simplified method for continuous monitoring of brain activity in the neonatal intensive care unit (NICU). Our objective was to describe current aEEG use in the United States.
Study Design An online survey was distributed to the American Academy of Pediatrics Section on Perinatal Pediatrics' list serve.
Result A total of 654 surveys were received; 55% of respondents reported using aEEG. aEEG was utilized more often in academic and levels III and IV NICUs; hypoxic-ischemic encephalopathy and suspected seizures were the most common indications for use. aEEG was primarily interpreted by neonatologists (87%), with approximately half reporting either self-teaching or hospital-based training for interpretation. For those not using aEEG, uncertain clinical benefit (40%) and cost (17%) were reported as barriers to use.
Conclusion More than half of neonatologists utilize aEEG, with practice variation by NICU setting. Barriers to wider adoption include education regarding potential benefit, training, and cost.
-
References
- 1 Maynard D, Prior PF, Scott DF. A continuous monitoring device for cerebral activity. Electroencephalogr Clin Neurophysiol 1969; 27 (7) 672-673
- 2 Azzopardi DV, Strohm B, Edwards AD , et al; TOBY Study Group. Moderate hypothermia to treat perinatal asphyxial encephalopathy. N Engl J Med 2009; 361 (14) 1349-1358
- 3 Gluckman PD, Wyatt JS, Azzopardi D , et al. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 2005; 365 (9460) 663-670
- 4 Papile LA, Baley JE, Benitz W , et al; Committee on Fetus and Newborn. Hypothermia and neonatal encephalopathy. Pediatrics 2014; 133 (6) 1146-1150
- 5 Clancy RR, Legido A, Lewis D. Occult neonatal seizures. Epilepsia 1988; 29 (3) 256-261
- 6 Boylan G, Burgoyne L, Moore C, O'Flaherty B, Rennie J. An international survey of EEG use in the neonatal intensive care unit. Acta Paediatr 2010; 99 (8) 1150-1155
- 7 Ponnusamy V, Nath P, Bissett L, Willis K, Clarke P. Current availability of cerebral function monitoring and hypothermia therapy in UK neonatal units. Arc Dis Child Fetal Neonatal Ed 2010; 95: F383-F384
- 8 Filan PM, Inder TE, Anderson PJ, Doyle LW, Hunt RW. Monitoring the neonatal brain: a survey of current practice among Australian and New Zealand neonatologists. J Paediatr Child Health 2007; 43 (7-8) 557-559
- 9 Glass HC, Kan J, Bonifacio SL, Ferriero DM. Neonatal seizures: treatment practices among term and preterm infants. Pediatr Neurol 2012; 46 (2) 111-115
- 10 American Academy of Pediatrics Committee on Fetus And Newborn. Levels of neonatal care. Pediatrics 2012; 130 (3) 587-597
- 11 Shellhaas RA, Chang T, Tsuchida T , et al. The American Clinical Neurophysiology Society's Guideline on continuous electroencephalography monitoring in neonates. J Clin Neurophysiol 2011; 28 (6) 611-617
- 12 Abend NS, Topjian AA, Gutierrez-Colina AM, Donnelly M, Clancy RR, Dlugos DJ. Impact of continuous EEG monitoring on clinical management in critically ill children. Neurocrit Care 2011; 15 (1) 70-75
- 13 Olischar M, Shany E, Aygün C , et al. Amplitude-integrated electroencephalography in newborns with inborn errors of metabolism. Neonatology 2012; 102 (3) 203-211
- 14 Olischar M, Klebermass K, Hengl B , et al. Cerebrospinal fluid drainage in posthaemorrhagic ventricular dilatation leads to improvement in amplitude-integrated electroencephalographic activity. Acta Paediatr 2009; 98 (6) 1002-1009
- 15 Olischar M, Klebermass K, Kuhle S, Hulek M, Messerschmidt A, Weninger M. Progressive posthemorrhagic hydrocephalus leads to changes of amplitude-integrated EEG activity in preterm infants. Childs Nerv Syst 2004; 20 (1) 41-45
- 16 Hellström-Westas L, Klette H, Thorngren-Jerneck K, Rosén I. Early prediction of outcome with aEEG in preterm infants with large intraventricular hemorrhages. Neuropediatrics 2001; 32 (6) 319-324
- 17 Whitelaw A, White RD. Training neonatal staff in recording and reporting continuous electroencephalography. Clin Perinatol 2006; 33 (3) 667-677 , vii
- 18 Kerur B, Salvador A, Arbeter A, Schutzman DL. Neonatal blood cultures: survey of neonatologists' practices. World J Pediatr 2012; 8 (3) 260-262
- 19 Permissive hypercapnia practices among neonatologists in the United States: Results of a national survey. Journal of Neonatal-Perinatal Medicine 2011; 4 (2) 111-117
- 20 Arzuaga BH, Meadow W. National variability in neonatal resuscitation practices at the limit of viability. Am J Perinatol 2014; 31 (6) 521-528