LAUSR

Introduction/Hypothesis: Full montage continuous EEG (cEEG) is gold standard for brain electrical monitoring in the Pediatric Intensive Care Unit (PICU); however, it is resource-intensive and not always available. SedLine is an FDA-approved fourelectrode frontal EEG device used in the operating room. It can be rapidly initiated with brief training and interpreted at the bedside. We hypothesized that use of SedLine would be feasible and safe in critically ill children and that background patterns from SedLine and cEEG interpreted by an electroencephalographer would agree >85% of the time. Methods: Patients >2 months of age undergoing clinically indicated cEEG in the PICU at a quaternary children’s hospital were eligible; they were excluded if they had a known severe allergy to adhesives or a problem with skin integrity. We obtained up to 24 hours of simultaneous SedLine EEG and cEEG. We calculated the percent of interpretable SedLine EEG recordings (feasibility) and the percent of subjects with skin irritation (safety). EEG data were divided into 30 minute epochs and randomly presented to a pediatric electroencephalographer for interpretation. Four frontal channels of cEEG data were presented to parallel SedLine EEG. EEG background categories were: 1) attenuated/featureless; 2) burst suppression/discontinuous; 3) continuous. Results: Simultaneous SedLine and cEEG data were collected from 8 subjects. None had skin irritation during monitoring or within 24 hours of removal. SedLine EEG tracings from 7 (87.5%) subjects were interpretable. SedLine data were not available for 1 due to technical issues but 0 were excluded due to artifact. Twenty-two epochs from the 7 subjects were analyzed (11 each from SedLine and cEEG). Background distribution of cEEG: 9.1% attenuated/featureless, 22.7% burst suppression/ discontinuous, 68.2% continuous. Overall agreement between cEEG and SedLine background interpretation: 68.2% (0% for attenuated/featureless, 40% for burst suppression/discontinuous, 86.7% for continuous). Conclusions: This pilot study showed SedLine EEG recording is feasible and safe in PICU patients. Agreement was lower than expected overall, but varied by background pattern with >85% agreement for continuous backgrounds. Ongoing evaluation of this technology for rapid beside use in select populations is warranted.