Amplitude Integrated EEG 3 and 6 Hours After Birth in Full Term Neonates with Hypoxic-ischaemic Encephalopathy

Overview

Journal Arch Dis Child Fetal Neonatal Ed

Specialties Gynecology & Obstetrics
Pediatrics

Date 1999 Jun 22

PMID 10375357

Citations 82

Authors

M C Toet

L Hellstrom-Westas

F Groenendaal

P Eken

L S de Vries

Affiliations

Soon will be listed here.

Abstract

Aim: To assess the prognostic value of amplitude integrated EEG (aEEG) 3 and 6 hours after birth.

Methods: Seventy three term, asphyxiated infants were studied (from two different centres), using the Cerebral Function Monitor (CFM Lectromed). The different aEEG tracings were compared using pattern recognition (flat tracing mainly isoelectric (FT); continuous extremely low voltage (CLV); burst-suppression (BS); discontinuous normal voltage (DNV); continuous normal voltage (CNV)) with subsequent outcome.

Results: Sixty eight infants were followed up for more than 12 months (range 12 months to 6 years). Twenty one out of 68 infants (31%) showed a change in pattern from 3 to 6 hours, but this was only significant in five cases (24%). In three this changed from BS to CNV with a normal outcome. One infant showed a change in pattern from CNV to FT and had a major handicap at follow up. Another infant showed a change in pattern from DNV to BS, and developed a major handicap at follow up. The other 16 infants did not have any significant changes in pattern: 11 infants had CLV, BS, or FT at 3 and 6 hours and died (n = 9) in the neonatal period or developed a major handicap (n = 2). Five infants had a CNV or DNV pattern at 3 and 6 hours, with a normal outcome. The sensitivity and specificity of BS, together with FT and CLV, for poor outcome at 3 hours was 0.85 and 0.77, respectively; at 6 hours 0.91 and 0.86, respectively. The positive predictive value (PPV) was 78% and the negative predictive value (NPV) 84% 3 hours after birth. At 6 hours the PPV was 86% and the NPV was 91%.

Conclusion: aEEG could be very useful for selecting those infants who might benefit from intervention after birth asphyxia.

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References

Amess P, Penrice J, Cady E, Lorek A, Wylezinska M, Cooper C . Mild hypothermia after severe transient hypoxia-ischemia reduces the delayed rise in cerebral lactate in the newborn piglet. Pediatr Res. 1997; 41(6):803-8. DOI: 10.1203/00006450-199706000-00002. View

King T, Jackson G, Josey A, Vedro D, Hawkins H, Burton K . The effect of profound umbilical artery acidemia in term neonates admitted to a newborn nursery. J Pediatr. 1998; 132(4):624-9. DOI: 10.1016/s0022-3476(98)70350-6. View

Vannucci R, Perlman J . Interventions for perinatal hypoxic-ischemic encephalopathy. Pediatrics. 1997; 100(6):1004-14. DOI: 10.1542/peds.100.6.1004. View

van Bel F, Shadid M, Moison R, Dorrepaal C, Fontijn J, Monteiro L . Effect of allopurinol on postasphyxial free radical formation, cerebral hemodynamics, and electrical brain activity. Pediatrics. 1998; 101(2):185-93. DOI: 10.1542/peds.101.2.185. View

Hall R, Hall F, Daily D . High-dose phenobarbital therapy in term newborn infants with severe perinatal asphyxia: a randomized, prospective study with three-year follow-up. J Pediatr. 1998; 132(2):345-8. DOI: 10.1016/s0022-3476(98)70458-5. View

Edwards A, Wyatt J, Thoresen M . Treatment of hypoxic-ischaemic brain damage by moderate hypothermia. Arch Dis Child Fetal Neonatal Ed. 1998; 78(2):F85-8. PMC: 1720772. DOI: 10.1136/fn.78.2.f85. View

Edwards A, Azzopardi D . Hypothermic neural rescue treatment: from laboratory to cotside?. Arch Dis Child Fetal Neonatal Ed. 1998; 78(2):F88-91. PMC: 1720757. DOI: 10.1136/fn.78.2.f88. View

Shankaran S . Identification of term infants at risk for neonatal morbidity. J Pediatr. 1998; 132(4):571-2. DOI: 10.1016/s0022-3476(98)70341-5. View

MONOD N, Pajot N, Guidasci S . The neonatal EEG: statistical studies and prognostic value in full-term and pre-term babies. Electroencephalogr Clin Neurophysiol. 1972; 32(5):529-44. DOI: 10.1016/0013-4694(72)90063-6. View

10.

Hagberg B, Hagberg G, OLOW I . The changing panorama of cerebral palsy in Sweden 1954-1970. I. Analysis of the general changes. Acta Paediatr Scand. 1975; 64(2):187-92. DOI: 10.1111/j.1651-2227.1975.tb03820.x. View

11.

Sarnat H, Sarnat M . Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976; 33(10):696-705. DOI: 10.1001/archneur.1976.00500100030012. View

12.

Watanabe K, Miyazaki S, Hara K, HAKAMADA S . Behavioral state cycles, background EEGs and prognosis of newborns with perinatal hypoxia. Electroencephalogr Clin Neurophysiol. 1980; 49(5-6):618-25. DOI: 10.1016/0013-4694(80)90402-2. View

13.

Holmes G, Rowe J, Hafford J, Schmidt R, Testa M, Zimmerman A . Prognostic value of the electroencephalogram in neonatal asphyxia. Electroencephalogr Clin Neurophysiol. 1982; 53(1):60-72. DOI: 10.1016/0013-4694(82)90106-7. View

14.

SVENNINGSEN N, Blennow G, Lindroth M, Gaddlin P, Ahlstrom H . Brain-orientated intensive care treatment in severe neonatal asphyxia. Effects of phenobarbitone protection. Arch Dis Child. 1982; 57(3):176-83. PMC: 1627585. DOI: 10.1136/adc.57.3.176. View

15.

BJERRE I, Hellstrom-Westas L, Rosen I, Svenningsen N . Monitoring of cerebral function after severe asphyxia in infancy. Arch Dis Child. 1983; 58(12):997-1002. PMC: 1628591. DOI: 10.1136/adc.58.12.997. View

16.

Archbald F, Verma U, TEJANI N, Handwerker S . Cerebral function monitor in the neonate. II: Birth asphyxia. Dev Med Child Neurol. 1984; 26(2):162-8. DOI: 10.1111/j.1469-8749.1984.tb04427.x. View

17.

Dijxhoorn M, Visser G, Huisjes H, Fidler V, Touwen B . The relation between umbilical pH values and neonatal neurological morbidity in full term appropriate-for-dates infants. Early Hum Dev. 1985; 11(1):33-42. DOI: 10.1016/0378-3782(85)90117-3. View

18.

Pezzani C, Relier J, MONOD N . Neonatal electroencephalography during the first twenty-four hours of life in full-term newborn infants. Neuropediatrics. 1986; 17(1):11-8. DOI: 10.1055/s-2008-1052492. View

19.

Thornberg E, Thiringer K . Normal pattern of the cerebral function monitor trace in term and preterm neonates. Acta Paediatr Scand. 1990; 79(1):20-5. DOI: 10.1111/j.1651-2227.1990.tb11324.x. View

20.

Gibson N, Graham M, Levene M . Somatosensory evoked potentials and outcome in perinatal asphyxia. Arch Dis Child. 1992; 67(4 Spec No):393-8. PMC: 1590514. DOI: 10.1136/adc.67.4_spec_no.393. View