Tele-cRCT
Trial question
What is the effect of tele-continuous electroencephalography in critically ill patients at risk of seizures?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
43.0% female
57.0% male
N = 254
254 patients (110 female, 144 male).
Inclusion criteria: critically ill patients aged ≥ 15 years at risk for developing nonconvulsive seizure/nonconvulsive status epilepticus.
Key exclusion criteria: post-cardiac arrest; advanced stage cancer; AIDS; alcoholic intoxication with or without delirium tremens; poor functional outcome at preadmission state; extensive lacerations, skin lesions, or surgical wound where electrode placement cannot be applied.
Interventions
N=128 tele-continuous EEG (monitoring tele-continuous electroencephalography for 24-72 hours).
N=126 tele-routine EEG (monitoring tele-routine electroencephalography for 30 minutes).
Primary outcome
Seizure detection rate
21.88%
14.29%
21.9 %
16.4 %
10.9 %
5.5 %
0.0 %
Tele-continuous
EEG
Tele-routine
EEG
No significant
difference ↔
No significant difference in seizure detection rate (21.88% vs. 14.29%; AD 7.59%, 95% CI -1.88 to 17.06).
Secondary outcomes
No significant difference in mean mRS score (4.08 points vs. 4.1 points; AD -0.02 points, 95% CI -0.43 to 0.4).
No significant difference in death (10.03% vs. 10.1%; HR 0.98, 95% CI 0.72 to 1.34).
No significant difference in mean mRS score at > 9 to 12 months (2.52 points vs. 2.5 points; AD 0.02 points, 95% CI -0.48 to 0.52).
Conclusion
In critically ill patients aged ≥ 15 years at risk for developing nonconvulsive seizure/nonconvulsive status epilepticus, tele-continuous EEG was not superior to tele-routine EEG with respect to seizure detection rate.
Reference
Chusak Limotai, Suda Jirasakuldej, Sattawut Wongwiangiunt et al. Efficacy of delivery of care with Tele-continuous EEG in critically ill patients: a multicenter randomized controlled trial (Tele-cRCT study) study. Crit Care. 2025 Jan 7;29(1):15.
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