CortiCare's company missions and gaol is to advance the field of neurotelemetry and cEEG monitoring by providing relavent peer-reviewed information illustrating the value of continuous cerebral monitoring using electrographic technology
On this page we will provide healthcare professionals with outstanding, timely and late breaking peer-reviewed articles, editorials, issues and reviews surrounding continuous EEG monitoring and the impact it has on patient care. Our goal and mission is to advance the practice of cEEG monitoring and neurotelemetry by presenting new clinical research that will influence the way hospitals monitor neurocritical care patients.
Introduction and Purpose
Critically ill patients are at high risk for a variety of neurologic insults, including seizures, ischemia, edema, infection, and increased intracranial pressure, which can result in permanent neurologic disability if untreated. Despite these risks, there are few techniques for continuously monitoring brain function...(read more)
Released: Consensus Statement: Indications, Technical Specifications and Clinical Practice of Continuous EEG Monitoring of Critically Ill Adults and Children
American Clinical Neurophysiology Society releases Draft Guideline for Critical Care EEG Monitoring (ccEEG)
Published April 2015
INDICATIONS FOR ccEEG
Table 1: Common neurological, medical, and surgical conditions associated with high likelihood of recording seizures on CCEEG
Published Dec 3, 2013 - Neurology
More ICU Patients Survive when cEEG is used versus routine EEG
(39% - 25% In-hospital mortality)
Continuous and routine EEG in intensive care: Utilization and outcomes, United States 2005-2009
Ney, JP, et.al., Neurology. 2013 Dec 3;81(23):2002-8
To evaluate the effect of intensive care unit continuous EEG (cEEG) monitoring on inpatient mortality, hospital charges, and length of stay.
This was a retrospective study of 8 million inpatient records of which 40,945 met the criteria representing 20% of all inpatient discharges in non-federal US hospitals. Adult ICU discharge records reporting mechanical ventilation and EEG (routine EEG or cEEG) were included. cEEG was compared with routine EEG alone in association with the primary outcome of in-hospital mortality and secondary outcomes of total hospital charges and length of stay.
CONCLUSIONS:
cEEG is favorably associated with inpatient survival (25% inpatient mortality vs 39% for routine EEG only) in mechanically ventilated patients, without adding significant charges to the hospital stay.
Published _________
As little as 10 Minutes of Seizures in One Hour of any Hour of cEEG is Associated with a greater probability of Neurological Decline
"We found that paediatric patients who experienced a seizure burden of more than 12 minutes in a given hour of cEEG recording had significantly worse short-term outcome, even after controlling for diagnosis and illness severity. "
These findings support the hypothesis that electrographic seizures independently contribute to brain injury and worsen outcome.
Increased Electrographic Seizures Burden among Critical Ill Children is Associated with a Decline in Neurologic Function at Hospital Discharge.
Payne, E., Hahn, C., et al, Brain, March, 2013
Prospective observational study of all infants and children admitted to our Pediatric and Cardiac Intensive Care Units who underwent clinically ordered video-cEEG monitoring over a 3-year period.
Seizure burden was quantified for each subject by calculating the maximum percentage of any hour that was occupied by Electrographic Seizures (ES).
A decline in Pediatric Cerebral Performance Category Scale (PCPC) score was observed in 67% of subjects, who had a mean maximum ES burden of 15.7% per hour, compared to 1.8% per hour for those without decline (p<0.0001).
Seizure Burden = % that seizure occupies in 1 hr of cEEG monitoring
ES burden remained significantly associated with PCPC decline, a diagnosis of acute brain injury, the presence of clinical seizures in the acute, or an unreactive EEG background.
For every 1% increase in maximum hourly ES burden, the odds of PCPC decline increased by 1.13 fold.
Editorial.
Gregory L. Holmes, MD Department of Neurological Sciences University of Vermont College of Medicine Burlington, Vermont, USA
To know or not to know: does EEG monitoring in the paediatric intensive care unit add anything besides cost?
Oxford Journals, Medicine, Brain Volume 137, Issue 5, Pp. 1276-1277.
2014 NCS Workshop
cEEG Grant Application
In conjunction with the Neurocritical Care Society 2014 Annual Conference Workshops entitled - Continuous EEG 101 and Continuous EEG 202, CortiCare is providing three (3) in-kind grants for $10,000 to organizations committed to developing and implementing a continuous EEG monitoring program at their hospital.
The objective for the grant is to inspire organizations that are contemplating a cEEG monitoring program to take the steps necessary to implement a program. To make that process easier CortiCare will provide the professional, administrative, technical and monitoring resources necessary to initiate a comprehensive cEEG program including 150 hours of continuous EEG monitoring at no charge to the grant recipients.
Those organizations interested in applying for the EEG Monitoring Grant can download the application and return it to the NCS Workshop Course Faculty listed on the application.
Grant recipients will be contacted the week of October 1, 2014 and posted here on this website.