ABSTRACT
Continuous electroencephalographic (EEG) monitoring is a relatively new modality in adult as well as in pediatric and neonatal intensive care units. Whereas a number of physiologic parameters such as electrocardiogram (ECG), heart rate, oxygen saturation, blood pressure, and temperature have long since been integrated into intensive care unit (ICU) monitoring systems, monitoring of the EEG, which directly reflects the functional state of the brain, has been used less commonly. There are probably a number of reasons for this:
The brain-generated EEG signal is of low amplitude, and easily contaminated by artifacts of both biologic and non-biologic origin. Interpretation of the EEG requires extensive training that includes good knowledge about sources of artifacts. Furthermore, due consideration has to be given to a number of factors such as level of wakefulness and administered medications, and in neonatal patients also to gestational age and postconceptional age.
A major disadvantage with intermittently recorded neonatal conventional EEGs is the difficulty, for the attending clinician as well as for the EEG specialist, to discriminate emerging trends of development of the electrocerebral activity over hours and days, which directly reflects clinically relevant pathophysiologic processes.
Even with the development of new electrode caps, the intensive care situation does not usually permit surveillance and maintenance of impedances and positions of multiple EEG recording electrodes on the scalp for any length of time exceeding a few hours.
