Evolution of Amplitude-Integrated Electroencephalogram As a Predictor of Outcome in Term Encephalopathic Neonates Receiving Therapeutic Hypothermia

Overview

Journal Am J Perinatol

Specialty Gynecology & Obstetrics

Date 2017 Sep 29

PMID 28958093

Citations 12

Authors

Elizabeth K Sewell

Gilbert Vezina

Taeun Chang

Tammy Tsuchida

Kari Harris

Michelande Ridore

Penny Glass

An N Massaro

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aims to evaluate the ability of (1) a novel amplitude-integrated electroencephalogram (aEEG) background evolution classification system; and (2) specific hour of life (HOL) cut points when observation of aEEG normalization and development of cycling can predict adverse neurological outcomes in infants with hypoxic-ischemic encephalopathy (HIE).

Study Design: Continuous aEEG data of term neonates with HIE were reviewed for background pattern and aEEG cycling from start of monitoring through rewarming. Infants were classified by overall background evolution pattern. Adverse outcomes were defined as death or severe magnetic resonance imaging injury, as well as developmental outcomes in a subset of patients. aEEG characteristics were compared between outcome groups by multivariate regression models, likelihood ratios (LR), and receiver operating characteristic (ROC) curve analyses.

Results: Overall, 80 infants receiving therapeutic hypothermia met the inclusion criteria. Background evolution pattern seemed to distinguish outcome groups more reliably than background pattern at discrete intervals in time (LR: 43.9, value < 0.001). Infants who did not reach discontinuous background by 15.5 HOL, cycling by 45.5 HOL, and normalization by 78 HOL were most likely to have adverse outcomes.

Conclusion: Evolution of aEEG in term neonates with HIE may be more useful for predicting outcome than evaluating aEEG at discrete intervals in time.

Citing Articles

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Progression of Amplitude-Integrated Electroencephalography and Neurological Outcomes in Neonates With Hypoxic-Ischemic Encephalopathy: A Single-Institution Cohort Study in Vietnam.

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Temperature dysregulation during therapeutic hypothermia predicts long-term outcome in neonates with HIE.

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Neonatal neuropalliative care.

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