Abstract
Introduction
Use of continuous EEG in the ICU setting is increasing. The EEG electrode continues to be a weak link in the chain from recording to interpretation. The technical difficulties of maintaining artifact-free, low impedance data collection are magnified by the ICU environment and prolonged duration of monitoring often required for these patients.
Case
We describe a case demonstrating the longest reported continuous use of subdermal wire electrodes.
Discussion
Subdermal wire electrodes offer a safe method to overcome technical challenges while maintaining high-recording quality. Their advantages and disadvantages are considered in specific circumstances and in comparison to other electrode types.
References
Jaitly R, Sgro JA, Towne AR, Ko D, DeLorenzo RJ. Prognostic value of EEG monitoring after status epilepticus: a prospective adult study. J Clin Neurophysiol. 1997;14(4):326–34. doi:10.1097/00004691-199707000-00005.
Vespa PM, Nuwer MR, Nenov V, et al. Increased incidence and impact of nonconvulsive and convulsive seizures after traumatic brain injury as detected by continuous electroencephalographic monitoring. J Neurosurg. 1999;91(5):750–60.
Hirsch LJ. Continuous EEG monitoring in the intensive care unit: an overview. J Clin Neurophysiol. 2004;21(5):332–40.
Jordan KG. Emergency EEG and continuous EEG monitoring in acute ischemic stroke. J Clin Neurophysiol. 2004;21(5):341–52.
Vespa PM, Nenov V, Nuwer MR. Continuous EEG monitoring in the intensive care unit: early findings and clinical efficacy. J Clin Neurophysiol. 1999;16(1):1–13. doi:10.1097/00004691-199901000-00001.
Kull LL, Emerson RG. Continuous EEG monitoring in the intensive care unit: technical and staffing considerations. J Clin Neurophysiol. 2005;22(2):107–18. doi:10.1097/01.WNP.0000158361.24544.2D.
Young CB, Campbell VC. EEG monitoring in the intesive care unit: pitfalls and caveats. J Clin Neurophysiol. 1999;16(1):40–5. doi:10.1097/00004691-199901000-00003.
Mirsattari SM, Davies-Schinkel C, Young GB, Sharpe MD, Ives JR, Lee DH. Usefulness of a 1.5 T MRI-compatible EEG electrode system for routine use in the intesive care unit of a tertiary care hospital. Epilepsy Res. 2009;84:28–32. doi:10.1016/j.eplepsyres.2008.12.002.
Young GB, Ives JR, Chapman MG, Mirsattari SM. A comparison of subdermal wire electrodes with collodion-applied disk electrodes in long-term EEG recordings in ICU. Clin Neurophysiol. 2006;117(6):1376–9. doi:10.1016/j.clinph.2006.02.006.
Hipler UC, Elsner P, Fluhr JW. Antifungal and antibacterial properties of a silver-loaded cellulosic fiber. J Biomed Mater Res B Appl Biomater. 2006;77(1):156–63. doi:10.1002/jbm.b.30413.
Kollef MH, Afessa B, Azueto A, Veremakis C, Kerr K, Margolis BD, et al. Silver coated endotracheal tubes and incidence of ventilator-associated pneumonia: the NASCENT randomized trial. JAMA. 2008;300(7):805–13. doi:10.1001/jama.300.7.805.
Goldschmidt H, Hahn U, Salwender HJ, Haas R, Jansen B, Wolbring P, et al. Prevention of catheter-related infections by silver coated central venous catheters in oncological patients. Zentralbl Bakteriol. 1995;283(2):215–23.
Ives JR. New chronic EEG electrode for critical/intensive care unit monitoring. J Clin Neurophysiol. 2005;22(2):119–23. doi:10.1097/01.WNP.0000152659.30753.47.
Quigg M, Shneker B, Domer P. Current practice in administration and clinical criteria of emergent EEG. J Clin Neurophysiol. 2001;18(2):162–5. doi:10.1097/00004691-200103000-00007.
Treiman DM, Meyers PD, Walton NY, Collins JF, Colling C, Rowan AJ, et al. A comparison of four treatments for generalized convulsive status epilepticus: Veterans Affairs Status Epilepticus Cooperative Study Group. N Engl J Med. 1998;339(12):792–8. doi:10.1056/NEJM199809173391202.
Prasad A, Worrall BB, Bertram EH, Bleck TP. Propofol and midazolam in the treatment of refractory status epilepticus. Epilepsia. 2001;42(3):380–6. doi:10.1046/j.1528-1157.2001.27500.x.
Alldredge BK, Gelb AM, Isaacs SM, Corry MD, Allen F, Ulrich S, et al. A comparison of lorazepam, diazepam and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med. 2001;345(9):631–7. doi:10.1056/NEJMoa002141.
Das RR, Lucey BP, Chou SHY, Espinosa PS, Zamani AA, Dworetzky BA, Bromfield EB, Lee JW. The utility of conductive plastic electrodes in prolonged ICU EEG monitoring. Neurocrit Care. 2008;(Sep):20. Epub ahead of print.
Fossi S, Amantini A, Grippo A, Innocenti P, Amadori A, Bucciardini L, et al. Continuous EEG–SEP monitoring of severely brain injured patients in NICU: methods and feasibility. Neurophysiol Clin. 2006;36:195–205. doi:10.1016/j.neucli.2006.09.001.
Claassen J, Hirsch LJ, Emerson RG, Bates JE, Thompson TB, Mayer SA. Continuous EEG monitoring and midazolam infusion for refractory nonconvulsive status epilepticus. Neurology. 2001;57(6):1036–42.
Rossetti AO, Reichhart MD, Schaller MD, Despland PA, Bogousslavsky J. Propofol treatment of refractory status epilepticus: a study of 31 episodes. Epilepsia. 2004;45(7):757–63. doi:10.1111/j.0013-9580.2004.01904.x.
Vespa PM, Nuwer MR, Juhász C, Alexander M, Nenov V, Martin N, et al. Early detection of vasospasm after acute subarachnoid hemorrhage using continuous EEG ICU monitoring. Electroencephalogr Clin Neurophysiol. 1997;103(6):607–15. doi:10.1016/S0013-4694(97)00071-0.
Pandian JD, Cascino GD, So EL, Manno E, Fulgham JR. Digital video-electroencephalographic monitoring in the neurological-neurosurgical intensive care unit: clinical features and outcome. Arch Neurol. 2004;61:1090–4. doi:10.1001/archneur.61.7.1090.
Claassen J, Mayer SA, Kowalski RG, Emerson RG, Hirsh LJ. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62:1743–8.
Acknowledgments
Subdermal wire electrodes purchased from Ives EEG Solutions, Manotick, Ontario, Canada.
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Martz, G.U., Hucek, C. & Quigg, M. Sixty Day Continuous Use of Subdermal Wire Electrodes for EEG Monitoring During Treatment of Status Epilepticus. Neurocrit Care 11, 223–227 (2009). https://doi.org/10.1007/s12028-009-9215-y
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DOI: https://doi.org/10.1007/s12028-009-9215-y