Exploring state changes/sleep-wake cycling in mechanically ventilated children using amplitude-integrated EEG.

OBJECTIVE

Critically ill children face multiple factors that disrupt sleep. There is a need for a continuous tool for monitoring sleep in critically ill children. Quantitative EEG parameters such as the amplitude-integrated electroencephalography (aEEG) may provide insights into sleep patterns. We wanted to characterize aEEG for background pattern and aEEG state changes/sleep-wake cycling (SWC) during mechanical ventilation in a cohort of critically ill children.

METHODS

EEG signals were recorded and transformed into aEEG. We created 3-hrs epochs and analysed a maximum of 10 data epochs for each patient. aEEG recordings were stratified by background patterns and sleep-wake cycling.

RESULTS

Seven-hundred-and-twenty-one epochs from 118 mechanically ventilated critically ill children with a median age of 4.5 months were available for analysis. Continuous normal voltage was observed in > 80 % of the epochs. Signal amplitude increased after two months of age, with amplitudes comparable to healthy awake children. aEEG state changes/SWC occurrence increased during intensive care stay, while reduced aEEG state changes/SWC was associated with higher mortality.

CONCLUSION

Most subjects showed aEEG evidence of aEEG state changes/SWC. The amplitude of the EEG in critically ill children was lower than that in healthy children.

SIGNIFICANCE: aEEG could be a promising modality for continuous sleep monitoring in critically ill children.