Early amplitude-integrated electroencephalography for monitoring neonates at high risk for brain injury

Variane, Gabriel Fernando Todeschi; Magalhães, Maurício; Gasperine, Renato; Alves, Heitor; Scoppetta, Thiago Luiz Pereira Donoso; Figueredo, Rodrigo de Jesus Gonçalves; Rodrigues, Francisco Paulo Martins; Netto, Alexandre; Mimica, Marcelo Jenne; Gallacci, Clery Bernardi

doi:10.1016/j.jped.2016.12.003

Cited by 21 publications

(11 citation statements)

References 29 publications

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“…The prolonged delivery can lead to neonatal asphyxia which leads to brain injury and ischemia and as a sequel altered brain activity. Our study agrees with Variane et al [18], where he studied 23 patients with perinatal asphyxia resulted in discontinuous low voltage pattern aEEG.…”

Section: Discussionsupporting

confidence: 93%

Amplitude EEG Changes in Preterm Infants at NICU of Al-Zahraa University Hospital

Reda¹,

Oshaiba²,

Mansour³

et al. 2021

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Background: With increase in the incidence of preterm birth, quality of life in premature infants who suffer from perinatal brain injury has become a major concern. Amplitude electroencephalogram has the advantages of being simple bedside monitoring for assessment of brain function and follow up in preterm neonates. Aim of Study: To evaluate the aEEG changes in preterm infants and compare it to cranial ultrasound. Patients and Methods: This was a prospective observational study conducted at the NICU of Al Zahraa University Hospital for a period from May 2020 to May 2021. Our study was conducted on 60 preterm infants (26 -36 w) in the first 7 days of life with exclusion of obvious congenital anomalies and hypoxic ischemic encephalopathy patients. Cranial ultrasound was performed on all the studied groups then aEEG recording was done for 4 hours. Results: The pattern of aEEG was discontinuous in patients with low gestational age and in infants small for gestational age. The pattern was also discontinuous in infants who had convulsions. Among our studied infants who had PROM, pre-eclampsia and experienced prolonged delivery, some infants had low voltage amplitude recording as well as infants with intraventricular hemorrhage grade III. Conclusion: This study confirms that aEEG background activity is strongly related to gestational age, birth weight, convulsions and IVH. Complications during delivery alter neonatal brain activity and aEEG background. Early aEEG combined with cranial ultrasound increases the sensitivity for detecting abnormal neurological outcome.

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Section: Discussionsupporting

confidence: 93%

Amplitude EEG Changes in Preterm Infants at NICU of Al-Zahraa University Hospital

Reda¹,

Oshaiba²,

Mansour³

et al. 2021

OJPed

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“…Cyclical changes in aEEG activity presented as mature sleep-wake cycling demonstrated more mature EEG activity and better prognosis. Some researchers argued that aEEG activity which did not have a mature sleep-wake cycle suggested immature EEG activity, as EEG amplitude did not show regular sine wave changes and the cycle did not last more than 20 min in quiet or active sleep [10,11]. In the present study, the sleep-wake cycle was classified into mature and immature patterns to facilitate cerebral function monitoring.…”

Section: Discussionmentioning

confidence: 83%

Amplitude-Integrated Electroencephalography for Early Diagnosis and Prognostic Prediction of Hypoxic Encephalopathy in Preterm Infants

et al. 2018

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BackgroundThe aim of this study was to analyze amplitude-integrated electroencephalography (aEEG) in early diagnosis and prognosis of hypoxic encephalopathy (HE) in premature infants.Material/MethodsThirty-six premature infants with HE who were treated in Linyi Central Hospital were enrolled into the study group, while 40 premature infants without HE were assigned into the control group. aEEG was conducted within 6 h after delivery to compare aEEG continuity, mature sleep-wake cycle, and maximum and minimum voltage in the 2 groups. Correlations between aEEG abnormalities and clinical grading, neurological prognosis, Apgar score, and blood gas were also analyzed among the premature infants with HE.ResultsCompared with the control group, there were reductions in the continuous rate of aEEG, mature sleep-wake cycle, and the minimum voltage, and an increase in the maximum voltage in the study group (all P<0.05). The study group had a higher abnormal rate of aEEG and a lower normal rate of aEEG than in the control group (both P<0.05). Spearman’s rank correlation coefficients for abnormal aEEG and clinical grade and poor neurological prognosis were 0.758 and 0.799, respectively. The sensitivity of abnormal aEEG in predicting severity of clinical grading was 100% with a specificity of 82.5%. The sensitivity of abnormal aEEG in predicting neurological prognosis was 100% with a specificity of 90.3%. The Apgar scores and blood glass pH of the infants with various abnormal rates of aEEG were significantly different at 1 min, 5 min, and 10 min after delivery (all P<0.05).ConclusionsHE in premature infants has specific aEEG characteristics, which can be used to predict the severity and prognosis of HE.

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“…Preterm infants : the incidence of seizures in preterm infants has been reported between 4 to 48%, and seizures were associated with adverse outcomes including IVH, white matter injury (WMI), cognitive impairment and neonatal death [ 13 , 16 , 59 , 60 ]. The presence of SWC and continuous background pattern in the first week of life were associated to good neurodevelopmental outcomes, while absence of SWC and abnormal background activity were associated with neonatal death, severe IVH, WMI and neurological impairment at 2 years of age [ 61 – 64 ]. In extremely premature newborns during the first days of life, the occurrence of episodes of hypoxia/hyperoxia, hemodynamic and ventilatory instability, and systemic hypotension with decreased cerebral flow are common.…”

Section: Discussionmentioning

confidence: 99%

Protecting brains and saving futures guidelines: A prospective, multicenter, and observational study on the use of telemedicine for neonatal neurocritical care in Brazil

et al. 2022

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Background Management of high-risk newborns should involve the use of standardized protocols and training, continuous and specialized brain monitoring with electroencephalography (EEG), amplitude integrated EEG, Near Infrared Spectroscopy, and neuroimaging. Brazil is a large country with disparities in health care assessment and some neonatal intensive care units (NICUs) are not well structured with trained personnel able to provide adequate neurocritical care. To reduce this existing gap, an advanced telemedicine model of neurocritical care called Protecting Brains and Saving Futures (PBSF) Guidelines was developed and implemented in a group of Brazilian NICUs. Methods A prospective, multicenter, and observational study will be conducted in all 20 Brazilian NICUs using the PBSF Guidelines as standard-of-care. All infants treated accordingly to the guidelines during Dec 2021 to Nov 2024 will be eligible. Ethical approval was obtained from participating centers. The primary objective is to describe adherence to the PBSF Guidelines and clinical outcomes, by center and over a 3-year period. Adherence will be measured by quantification of neuromonitoring, neuroimaging exams, sub-specialties consultation, and clinical case discussions and videoconference meetings. Clinical outcomes of interest are detection of seizures during hospitalization, use of anticonvulsants, inotropes, and fluid resuscitation, death before hospital discharge, length of hospital stay, and referral of patients to specialized follow-up. Discussion The study will provide evaluation of PBSF Guidelines adherence and its impact on clinical outcomes. Thus, data from this large prospective, multicenter, and observational study will help determine whether neonatal neurocritical care via telemedicine can be effective. Ultimately, it may offer the necessary framework for larger scale implementation and development of research projects using remote neuromonitoring. Trial registration NCT03786497, Registered 26 December 2018, https://www.clinicaltrials.gov/ct2/show/NCT03786497?term=protecting+brains+and+saving+futures&draw=2&rank=1.

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Early amplitude-integrated electroencephalography for monitoring neonates at high risk for brain injury

Abstract: This study supports previous results and demonstrates the utility of amplitude-integrated electroencephalography for monitoring brain function and predicting early outcome in the studied groups of infants at high risk for brain injury.

Cited by 21 publications

References 29 publications

Amplitude EEG Changes in Preterm Infants at NICU of Al-Zahraa University Hospital

Amplitude EEG Changes in Preterm Infants at NICU of Al-Zahraa University Hospital

Amplitude-Integrated Electroencephalography for Early Diagnosis and Prognostic Prediction of Hypoxic Encephalopathy in Preterm Infants

Protecting brains and saving futures guidelines: A prospective, multicenter, and observational study on the use of telemedicine for neonatal neurocritical care in Brazil

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