Assessing the Feasibility of Providing a Real-Time Response to Seizures Detected With Continuous Long-Term Neonatal Electroencephalography Monitoring.
Purpose: Continuous video electroencephalography (cEEG) monitoring is the recommended gold standard of care for at-risk neonates but is not available in many Neonatal Intensive Care Units (NICUs). To conduct a randomized treatment trial of levetiracetam for the first-line treatment of neonatal seizu...
| Publicado en: | Journal of Clinical Neurophysiology Vol. 36; no. 1; pp. 9 - 14 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Jan2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=134081348&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 134081348 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07360258 8CL jtl: Journal of Clinical Neurophysiology issn: 07360258 maglogo: N pubinfo: dt: Jan2019 vid: 36 iid: 1 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 134081348 134081348 NLM30289769 10.1097/WNP.0000000000000525 NLM30289769 134081348 ppf: 9 ppct: 5 formats: tig: atl: Assessing the Feasibility of Providing a Real-Time Response to Seizures Detected With Continuous Long-Term Neonatal Electroencephalography Monitoring. aug: au: Sharpe, Cynthia Davis, Suzanne L. Reiner, Gail E. Lee, Lilly I. Gold, Jeff J. Nespeca, Mark Wang, Sonya G. Joe, Priscilla Kuperman, Rachel Gardner, Marissa Honold, Jose Lane, Brian Knodel, Ellen Rowe, Deborah Battin, Malcolm R. Bridge, Renee Goodmar, Jim Castro, Ben Rasmussen, Maynard Arnell, Kathy affil: Paediatric Neurology, Auckland District Health Board, Auckland, New Zealand sug: subj: Seizures Diagnosis Intensive Care, Neonatal Methods Electroencephalography Methods Monitoring, Physiologic Methods Health Personnel Qualitative Studies Brain Physiopathology Interviews Intensive Care Units, Neonatal Infant, Newborn Family Psychosocial Factors Pilot Studies Seizures Physiopathology Software Information Science Algorithms Time Factors Questionnaires Scales Infant, Newborn: birth-1 month ab: Purpose: Continuous video electroencephalography (cEEG) monitoring is the recommended gold standard of care for at-risk neonates but is not available in many Neonatal Intensive Care Units (NICUs). To conduct a randomized treatment trial of levetiracetam for the first-line treatment of neonatal seizures (the NEOLEV2 trial), we developed a monitoring infrastructure at five NICUs, implementing recent technological advancements to provide continuous video EEG monitoring and real-time response to seizure detection. Here, we report on the feasibility of providing this level of care.Methods: Twenty-five key informant interviews were conducted with study neurologists, neonatologists, coordinators, and EEG technicians from the commercial EEG monitoring company Corticare. A general inductive approach was used to analyze these qualitative data.Results: A robust infrastructure for continuous video EEG monitoring, remote review, and real-time seizure detection was established at all sites. At the time of this survey, 260 babies had been recruited and monitored for 2 to 6 days. The EEG technician review by the commercial EEG monitoring company was reassuring to families and neonatologists and led to earlier detection of seizures but did not reduce work load for neurologists. Neurologists found the automated neonatal seizure detector algorithm provided by the EEG software company Persyst useful, but the accuracy of the algorithm was not such that it could be used without review by human expert. Placement of EEG electrodes to initiate monitoring, especially after hours, remains problematic.Conclusions: Technological advancements have made it possible to provide at-risk neonates with continuous video EEG monitoring, real-time detection of and response to seizures. However, this standard of care remains unfeasible in usual clinical practice. Chief obstacles remain starting a recording and resourcing the real-time specialist review of suspect seizures. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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