Feasibility and Agreement of a Self-Adhesive EEG Electrode Set Versus Conventional EEG in Postanoxic Coma

Background Electrode application for EEG prognostication in postanoxic coma patients is labor-intensive.We studied the usability of a self-adhesive forehead EEG electrode (Bittium BrainStatus TM ) and compared the accuracy of background classification with conventional EEG.Methods In 51 postanoxic coma patients, simultaneous monitoring using conventional EEG and a forehead electrode was performed.5-minute EEG fragments were classified according to the ACNS criteria by four experts, based on the conventional montage, the forehead electrode, and a montage based on the standard EEG recording but visualized as the forehead electrode.Results Forehead electrode recordings were of sufficient quality in 74.1% of fragments.Agreement was moderate for standard EEG versus the forehead electrode (: 0.56), and near perfect for conventional EEG versus conventional EEG visualized as the forehead electrode (: 0.85).Due to higher noise levels, detection rates of discontinuous and suppressed patterns were reduced.Conclusion EEG forehead electrode recordings were interpretable in a large proportion of cases.If signal quality is insufficient for assessment, additional standard EEG should be performed to allow definitive assessment.Significance The use of a self-adhesive forehead electrode set has the potential to substantially reduce EEG technician workload in the ICU and suggests considerable potential benefit as a screening-oriented EEG monitoring strategy in postanoxic coma.