Journal Article Ahead of print
PubMed: 42424670 DOI: 10.1016/j.clinph.2026.2112328
Exploring state changes/sleep-wake cycling in mechanically ventilated children using amplitude-integrated EEG.
Clin Neurophysiol 190:2112328
Authors: Douwe van der Steen, Alette A Koopman, Eline Oppersma, Robert G T Blokpoel, Saptharishi Lalgudi Ganesan, Martin C J Kneyber
Affiliations
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Centre Groningen, the University of Groningen, Groningen, the Netherlands.
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Centre Groningen, the University of Groningen, Groningen, the Netherlands.
- Cardiovascular and Respiratory Physiology Group, TechMed Centre, University of Twente, the Netherlands.
- Departments of Paediatrics and Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Paediatric Critical Care Medicine, Children's Hospital - London Health Sciences Centre, London, ON, Canada.
- Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Centre Groningen, the University of Groningen, Groningen, the Netherlands; Critical Care, Anaesthesiology, Peri-operative & Emergency Medicine (CAPE), The University of Groningen, Groningen, the Netherlands.
Abstract
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.
MeSH
Sleep, Polysomnography, Critical Illness, Neurophysiology, Child