Introduction to the CFM and the Clinical Applications

Abstract

The cerebral function monitor is a device for trend monitoring of changes in the amplitude of the electroencephalogram, typically recorded from 1-2 pairs of electrodes. Initially developed and introduced to monitor cerebral activity in encephalopathic adult patients or during anaesthesia it is now most widely used in newborns with encephalopathy to assess the severity of encephalopathy and for prognosis. The time to recovery from a moderately/severely abnormal amplitude integrated electroencephalogram trace to a normal trace is strongly predictive of subsequent neurological outcome following neonatal hypoxic ischaemic encephalopathy, including in newborns receiving neuroprotective treatment with prolonged moderate hypothermia. The cerebral function monitor is also used for seizure detection and to monitor response to anticonvulsant therapies. Amplitude integrated electroencephalography compares well with standard electroencephalography when used to assess the severity of neonatal encephalopathy but a standard electroencephalogram is still required to provide additional important information about changes in frequency, and in the synchrony and distribution and other characteristics of cerebral cortical activity. The role of the amplitude integrated electroencephalogram to identify brain injury in preterm infants remains to be determined.