Abstracts

Rationale: The aim of this study was to estimate the proportion of patients who undergo an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit (ICU): traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE).  Methods: We performed a retrospective cross-sectional descriptive study utilizing the Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and is based on discharge reports created by hospitals for billing purposes. We evaluated the use of electroencephalogram (EEG) or video-electroencephalogram (vEEG) in critically ill children who were mechanically ventilated. Results: The KID database had a population of approximately 6,000,000 pediatric admissions. Among 22,127 admissions of critically ill children who had mechanical ventilation, 1504 (6.8%) admissions had ECMO, 9201 (41.6%) TBI, 4068 (18.4%) HIE, 2774 (12.5%) cardiac arrest, and 4580 (20.7%) cardiac surgery. All five conditions had a higher proportion of males, with the highest (69.84%) in the TBI group. The mortality rates ranged from 7.02% to 39.92% (lowest in cardiac surgery and highest in ECMO). The estimated use of EEG was 1.61% in cardiac surgery, 4.10% in TBI, 7.19% in ECMO, 8.21% in cardiac arrest, and 12.14% in HIE, with an overall use of 5.79% (Figure 1). Conclusions: Among common indications for EEG monitoring in critically ill children and neonates, the estimated proportion of patients who undergo an EEG is low. This indicates the need to implement existing guidelines for EEG monitoring to better evaluate the conditions of critically ill children and neonates. Funding: Epilepsy Research Fund