Author Interviews, Critical Care - Intensive Care - ICUs, Yale / 09.11.2013

MedicalResearch.com Interview with: John Ney, MD, MPH Clinical Assistant Professor, Department of Neurology, University of Washington [email protected] MedicalResearch.com: What are the main findings of the study? Dr. Ney: My colleagues and I used a large, publicly available dataset to examine the usage and effectiveness of electroencephalography (EEG) in adult intensive care units (ICUs) in the United States over a five year period.  We compared routine EEG, which consists of a portable machine hooked up to the patient to record brainwaves for a short duration, usually 20-40 minutes, with continuous EEG monitoring, where a patient’s brainwaves are recorded continuously for 24 hours or more and examined, ideally in real-time.  Because most patients in the ICU are comatose, we have generally poor and crude indicators of their brain function.  ICU patients are particularly at risk for non-convulsive seizures, where the brain is seizing, but there are few outward signs of a seizure.  EEG is the only means of detecting non-convulsive seizures, and is useful in determining the brain’s reactions to drugs, monitoring for stroke and other abnormal activity. Our main finding is that ICU patients receiving continuous EEG monitoring was associated with increased survival relative to those who received routine EEG only.    In our sample, 39% of ICU patients who received routine EEG died compared to only 25% of those with continuous EEG monitoring. This finding was both substantial and statistically significant, even after adjustment for age and other demographics, clinical disease comorbidity severity measures, and hospital factors.  Although continuous EEG monitoring was more expensive, the increase in hospital charges were not significant after adjustment. (more…)