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Alternative sensor montage for Index based EEG monitoring. A systematic review

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Abstract

The main objective of this systematic review is to assess the reliability of alternative positions of processed electroencephalogram sensors for depth of anesthesia monitoring and its applicability in clinical practice. A systematic search was conducted in PubMed, Embase, Cochrane Library, Clinical trial.gov in accordance with reporting guidelines of PRISMA statement together with the following sources: Google and Google Scholar. We considered eligible prospective studies, written in the English language. The last search was run on the August 2023. Risk of bias and quality assessment were performed. Data extraction was performed by two authors and results were synthesized narratively owing to the heterogeneity of the included studies. Thirteen prospective observational studies (438 patients) were included in the systematic review after the final assessment, with significant diversity in study design. Most studies had a low risk of bias but due to lack of information in one key domain of bias (Bias due to missing data) the overall judgement would be No Information. However, there is no clear indication that the studies are at serious or critical risk of bias. Bearing in mind, the heterogeneity and small sample size of the included studies, current evidence suggests that the alternative infraorbital sensor position is the most comparable for clinical use when the standard sensor position in the forehead is not possible.

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Acknowledgements

The authors acknowledge Philip Anderson for his contribution to the grammar and spelling revision of the manuscript.

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The authors received no financial support for the authorship and publication of this article.

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Authors and Affiliations

  1. Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

    Boris Tufegdzic, Francisco Lobo & Massimo Lamperti

  2. Neurology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE

    Eugene Achi

  3. Fondazione IRCCS Istituto Neurologico “Carlo Besta”, Milan, Italy

    Saba Motta & Carla Carozzi

Authors
  1. Boris Tufegdzic
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  2. Francisco Lobo
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  3. Eugene Achi
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  4. Saba Motta
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  6. Massimo Lamperti
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Contributions

Author contributions to the study and manuscript preparation include the following. Conception and design: all authors; Drafting the article: all authors; Data collection: Saba Motta; Critically revising the article: all authors; Reviewed submitted version of manuscript: all authors; Approved the final version of the manuscript on behalf of all authors: Boris Tufegdzic; Study supervision: Boris Tufegdzic.

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Correspondence to Boris Tufegdzic.

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The proposed systematic review does not require ethical approval, as it is conducted at the study level and does not involve individual patient-level data. Results will be disseminated by data sharing via academically established means, presentation at local and national scientific meetings and publication as a peer-reviewed manuscript.

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Tufegdzic, B., Lobo, F., Achi, E. et al. Alternative sensor montage for Index based EEG monitoring. A systematic review. J Clin Monit Comput (2024). https://doi.org/10.1007/s10877-024-01162-1

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