Advice

Summary

Summary

  • The technology described in this briefing is CerebAir. It is used for continuous electroencephalogram (EEG) monitoring of people who are critically ill in intensive care.

  • The innovative aspects are that it is a wireless headset with pre-positioned electrodes, which is designed to be quicker and easier to apply than conventional continuous EEG. Specialist training is not needed to apply the headset and data can be reviewed by neurophysiologists remotely.

  • The intended place in the clinical pathway would be as an alternative to conventional continuous EEG in people who are critically ill in intensive care.

  • The main points from the evidence summarised in this briefing are from 3 studies (1 retrospective and 2 prospective single-centre observational studies) including 157 adults in intensive care. They show that CerebAir is quicker to apply than conventional EEG and has good sensitivity and specificity for detecting abnormal EEG activity. Skin redness may happen with longer monitoring periods (over 15 hours) but is likely to resolve without needing medical treatment.

  • Key uncertainties around the evidence or technology are that all studies had small sample sizes and no study examined the effect on clinical outcomes or treatment decision making.

  • Experts advised that the technology has potential to decrease time to diagnosis, prognosis, and treatment, and reduce secondary brain injuries. However, using CerebAir may increase the number of continuous EEG recordings being made and the time demands on neurophysiologists to interpret the data. The device may cause minor local skin injury and it is unclear if the device can be used on people after surgery on the skull.

  • The cost of purchasing CerebAir is £20,000 to £30,000 depending on the hardware configuration. There are additional consumable costs for the pre-gelled electrodes that cost £89 per use. The cost of purchasing a standard portable EEG machine (including laptop, associated software and video camera) is estimated to be between £10,000 and £20,000. These costs do not include the cost of EEG interpretation. All costs exclude VAT.