EEG monitoring duration to identify electroencephalographic seizures in critically ill children.

Objectives Determine the optimal duration of continuous EEG monitoring (CEEG) for electrographic seizure (ES) identification in critically ill children. Methods We performed a prospective observational cohort study of 719 consecutive critically ill children with encephalopathy. We evaluated baseline clinical risk factors (age and prior clinically evident seizures) and emergent CEEG risk factors (epileptiform discharges and ictal-interictal continuum patterns) using a multi-state survival model. For each subgroup, we determined the CEEG duration for which the risk of ES was Results ES occurred in 184 children (26%). Patients achieved Conclusions A model derived from 2 baseline clinical risk factors and emergent EEG risk factors would allow clinicians to implement personalized strategies that optimally target limited CEEG resources. This would enable more widespread use of CEEG-guided management as a potential neuroprotective strategy.