PRO-E5 EEG Electrodes: Amplitude-Integrated Electroencephalography (Needles for aEEG). Needle Electrodes for the Neonatal Intensive Care Unit
The Electrode Store's PRO-E5 low impedance needle electrodes are used to monitor brain function in the neonatal intensive care unit (NICU) for a longer period of time and with more convenience/accessibility than traditional EEGs. In traditional EEGs (short ~60-minute assessments), many high-risk neonates have no seizures, but they may have one or more within 24 hours. This makes longer-term brain monitoring in newborns very valuable! *aEEG in the Neonatal ICU is becoming more widespread as studies have shown their value. More on the ease and convenience of amplitude-integrated EEG (aEEG) in a future post.
The PRO-E5 needles have proven to be great for helping detect and monitor neonatal seizures in aEEG, and for monitoring the effects on the brain of different treatments in neonates. They have been on the market for 15+ years, and their quality, safety features, and consistency from one needle to the next is why the devices are popular amongst neonatologists.
When do I use PRO-E5 needle electrodes instead of surface electrodes?
When deciding whether to use low impedance needle electrodes or hydrogel surface electrodes, there are several factors to consider. Generally, needle electrodes are preferred under any of the following conditions:
- When the length of monitoring is likely going to exceed 12 hours (hydrogels dry up over time, and the needles will remain effective for as long as the hospital's infection control policy allows for (up to 3-7 days))
- When significantly lower impedance is desired (~0-2 kOhms, compared to ~7-17 kOhms in hydrogels)
- When time is of the essence (setup time for the low impedance needles is considerably lower than for hydrogels)
Reusable metal surface electrodes present many of the same challenges as hydrogels and have the added risk of cross-contamination and occasional skin irritation.
Other factors to consider:
- The neonate's tolerance of handling the skin preparation required by hydrogels (needles require less abrasive skin prep)
- Hair, skin condition, and age
The PRO-E5's come in a pouch of 4 active needle electrodes (two purple, two black), and are used with a reference hydrogel electrode on the neonate's back or chest. The needles are typically placed in a 3 electrode cross-cerebral configuration (2 needles (P3 and P4), 1 reference) or 5 electrode bilateral configuration (4 needles (C3/P3 and C4/P4), 1 reference) on the neonate, with the reference electrode on the back or chest.
The baby-blue cap ("Protectrode" cap) is also meant to minimize the risk of accidental needle sticks upon removing the needle from the patient.
- Hold the blue cap and gently pull back on the lead-wire until the needle is fully retracted inside the cap, then discard in the sharps container.
PRO-E5 key takeaways:
• For 1 to 3 channel bedside aEEG monitoring
• Established product with high quality, safety, and consistency (hospitals have been using these needles for 15+ years)
• Compatible with OBM, CFM, and a variety of other EEG / aEEG monitors
• Low impedance (~0-2 kOhms, compared to ~7-17 kOhms in hydrogels)
• Effective until removed (hospitals generally leave them in for up to 3-7 days)
• Minimal risk of needle stick with the Protectrode™ baby-blue cap feature (recapping is as simple as pulling the lead-wire back through the baby-blue safety cap)
The Electrode Store is the manufacturer of the PRO-E5 / OBM00046, and is now selling these directly to end users in the USA and distributors outside the US.