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

H ter Horst, C Sommer, JM Fock, TW van Weerden, AF Bos*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

123 Citations (Scopus)

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 It 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

Original languageEnglish
Pages (from-to)1026-1033
Number of pages8
JournalPediatric Research
Volume55
Issue number6
DOIs
Publication statusPublished - Jun-2004

Keywords

  • HYPOXIC-ISCHEMIC ENCEPHALOPATHY
  • CEREBRAL FUNCTION MONITOR
  • FULL-TERM INFANTS
  • PERINATAL ASPHYXIA
  • CHANGING PANORAMA
  • PREDICTIVE VALUE
  • SEIZURES
  • ELECTROENCEPHALOGRAPHY
  • BRAIN
  • NEWBORNS

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