Prognostic significance of amplitude-integrated EEG during the first 72 hours after birth in severely asphyxiated neonates - PubMed (original) (raw)

Prognostic significance of amplitude-integrated EEG during the first 72 hours after birth in severely asphyxiated neonates

Hendrik J ter Horst et al. Pediatr Res. 2004 Jun.

Abstract

Amplitude-integrated EEG (aEEG) is used to select patients for neuroprotective therapy after perinatal asphyxia because of its prognostic accuracy within several hours after birth. We aimed to determine the natural course of aEEG patterns during the first 72 h of life, in relation to neurologic outcome, in a group of severely asphyxiated term infants. Thirty infants, admitted to our neonatal intensive care unit from October 1998 until February 2001, were studied retrospectively. The aEEG traces obtained during the first 72 h after birth were assessed by pattern recognition: continuous normal voltage (CNV), discontinuous normal voltage (DNV), burst suppression (BS), continuous low voltage, and flat trace. Epileptic activity was also determined. The course of aEEG patterns was examined in relation to neurologic findings at 24 mo. Initially, 17 of 30 infants had severely abnormal aEEG patterns (BS or worse), which changed spontaneously to normal voltage patterns (CNV, DNV) in 7 within 48 h. The sooner the abnormalities on aEEG disappeared, the better the prognosis. The likelihood ratio of BS or worse for adverse outcome was 2.7 (95% confidence interval 1.4-5.0) between 0 and 6 h and increased to a highest value of 19 (95% confidence interval 2.8-128) between 24 and 36 h; after 48 h, it was not significant. Normal voltage patterns (CNV and DNV) up to 48 h of life were predictive for normal neurologic outcomes (negative likelihood ratios <0.3). Our findings indicate that the course of aEEG patterns adds to the prognostic value of aEEG monitoring in asphyxiated infants. Spontaneous recovery of severely abnormal aEEG patterns is not uncommon.

PubMed Disclaimer

Similar articles

• Recovery of amplitude integrated electroencephalographic background patterns within 24 hours of perinatal asphyxia.
  van Rooij LG, Toet MC, Osredkar D, van Huffelen AC, Groenendaal F, de Vries LS. van Rooij LG, et al. Arch Dis Child Fetal Neonatal Ed. 2005 May;90(3):F245-51. doi: 10.1136/adc.2004.064964. Arch Dis Child Fetal Neonatal Ed. 2005. PMID: 15846017 Free PMC article.
• Midazolam and amplitude-integrated EEG in asphyxiated full-term neonates.
  van Leuven K, Groenendaal F, Toet MC, Schobben AF, Bos SA, de Vries LS, Rademaker CM. van Leuven K, et al. Acta Paediatr. 2004 Sep;93(9):1221-7. Acta Paediatr. 2004. PMID: 15384888 Clinical Trial.
• Cerebral function monitoring in neonates with perinatal asphyxia--preliminary results.
  Lukásková J, Tomsíková Z, Kokstein Z. Lukásková J, et al. Neuro Endocrinol Lett. 2008 Aug;29(4):522-8. Neuro Endocrinol Lett. 2008. PMID: 18766163
• Predictive value of amplitude-integrated EEG (aEEG) after rescue hypothermic neuroprotection for hypoxic ischemic encephalopathy: a meta-analysis.
  Chandrasekaran M, Chaban B, Montaldo P, Thayyil S. Chandrasekaran M, et al. J Perinatol. 2017 Jun;37(6):684-689. doi: 10.1038/jp.2017.14. Epub 2017 Mar 2. J Perinatol. 2017. PMID: 28252661 Review.
• Continuous brain-function monitoring: state of the art in clinical practice.
  Hellström-Westas L, Rosén I. Hellström-Westas L, et al. Semin Fetal Neonatal Med. 2006 Dec;11(6):503-11. doi: 10.1016/j.siny.2006.07.011. Epub 2006 Oct 24. Semin Fetal Neonatal Med. 2006. PMID: 17067863 Review.

Cited by

• Newborns' sleep-wake cycle development on amplitude integrated electroencephalography.
  Li XF, Zhou YX, Zhang L. Li XF, et al. World J Pediatr. 2016 Aug;12(3):327-334. doi: 10.1007/s12519-016-0026-x. Epub 2016 Jun 29. World J Pediatr. 2016. PMID: 27351568
• Early amplitude-integrated EEG monitoring 6 h after birth predicts long-term neurodevelopment of asphyxiated late preterm infants.
  Jiang CM, Yang YH, Chen LQ, Shuai XH, Lu H, Xiang JH, Liu ZL, Zhu YX, Xu RY, Zhu DR, Huang XM. Jiang CM, et al. Eur J Pediatr. 2015 Aug;174(8):1043-52. doi: 10.1007/s00431-015-2490-z. Epub 2015 Mar 3. Eur J Pediatr. 2015. PMID: 25727101
• Impact of amplitude-integrated electroencephalograms on clinical care for neonates with seizures.
  Shellhaas RA, Barks AK. Shellhaas RA, et al. Pediatr Neurol. 2012 Jan;46(1):32-5. doi: 10.1016/j.pediatrneurol.2011.11.004. Pediatr Neurol. 2012. PMID: 22196488 Free PMC article.
• The prognostic value of amplitude-integrated EEG in full-term neonates with seizures.
  Zhang D, Ding H, Liu L, Hou X, Sun G, Li L, Liu Y, Zhou C, Gu R, Luo Y. Zhang D, et al. PLoS One. 2013 Nov 13;8(11):e78960. doi: 10.1371/journal.pone.0078960. eCollection 2013. PLoS One. 2013. PMID: 24236076 Free PMC article.
• The Role of Amplitude-Integrated Electroencephalography (aEEG) in Monitoring Infants with Neonatal Seizures and Predicting Their Neurodevelopmental Outcome.
  Doandes FM, Manea AM, Lungu N, Brandibur T, Cioboata D, Costescu OC, Zaharie M, Boia M. Doandes FM, et al. Children (Basel). 2023 May 3;10(5):833. doi: 10.3390/children10050833. Children (Basel). 2023. PMID: 37238381 Free PMC article.

Publication types

MeSH terms

LinkOut - more resources

• Full Text Sources

  • Nature Publishing Group
  • Ovid Technologies, Inc.