Electroencephalography monitoring in the neonatal intensive care unit: a Chinese perspective

Background: Electroencephalography (EEG) is an accessible technique for bedside monitoring of the cerebral function in the neonatal intensive care unit (NICU). The popularization of EEG in the field of newborns in China is relatively late compared with western countries. To learn more about current practices and improvement of EEG monitoring, we conducted a survey to describe current utilization of EEG in NICU in China. Methods: A cross-sectional electronic survey with 21-items about EEG using in NICU was administered for pediatricians in China on the official website of "Questionnaire Star". Results: A total of 251 participants were involved, in which 64% of them reported using EEG. EEG was employed in NICUs of Children's hospitals (97%), and grade III, class A hospitals (69%). Besides, neonatal encephalopathy and suspected seizures were the most common indications for use. In clinical practice, the vast majority of physicians managed their patients on the basis of EEG (93%). Pediatricians prefer to use conventional video-EEG (cEEG) to detect seizures and make the diagnosis of encephalopathy. Both amplitude integrated EEG (aEEG) (78%) and cEEG (56%) were mainly interpreted by neonatologists. However, only 56% of respondents had ever taken a formal EEG training course. Overall, 96% of the respondents reported that they would be interested in attending an education session on EEG in the NICU. aEEG interpretation was the most interesting part to learn (81%). For those who were not using EEG, cost (43%) and difficulty interpretation (30%) were reported as barriers to use. Conclusions: The utilization rate of EEG in NICU in China is significantly lower than the international level. There is an urgent need for standardized training and financial support for neonatologists in the use of EEG and interpretation of aEEG results.