Background electroencephalographic (EEG) activities of very preterm infants born at less than 27 weeks gestation: a study on the degree of continuity

Hayakawa, Masahiro; Okumura, Akihisa; Hayakawa, Fumio; Watanabe, Kazuyoshi; Ohshiro, Makoto; Kato, Yuuichi; Takahashi, R.; Tauchi, Nobuo

doi:10.1136/fn.84.3.f163

Cited by 92 publications

(60 citation statements)

References 23 publications

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“…The strong trends in EEG parameters in relation to CGA noted in our cohort are consistent with the results of other studies (16,17). Indeed, in our study, IBIs decrease with increased CGA (17).…”

Section: Permissive Hypercapnia and Eegsupporting

confidence: 82%

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Effect of permissive hypercapnia on background cerebral electrical activity in premature babies

et al. 2014

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ArticlesClinical Investigation nature publishing group background: Permissive hypercapnia is routinely practiced in neonatal intensive care units. The effect of permissive hypercapnia on the preterm brain and brain electrical activity is unknown. In this study, we aimed to determine the effect of chronic changes in partial pressure of blood carbon dioxide (PcO 2 ) on brain electrical activity in preterm newborn babies born at or before 32 wk gestation. Methods: Eighty-three 1-h long digital electroencephalography (EEG) recordings were performed once a week for 4 wk on 25 babies with median gestational age of 29 wk (range: 23-32) after 48 h of age. Capillary blood gas measurements were performed midway through EEG recordings. results: There are associations between EEG parameters and blood pH, PcO 2 , and blood glucose concentration. However, there are also strong and complex associations with gestational age and substantial individual patient effects that make it difficult to demonstrate predictive associations. PcO 2 and bicarbonate are significantly correlated with relative power of θ EEG band and Δ EEG band respectively after adjustment for age and intrababy correlations, but after allowing for multiple testing these relationships are of borderline statistical significance. conclusion: Compensated respiratory acidosis may affect EEG by increased delta wave activity in preterm babies born before 32 wk gestation.

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Section: Permissive Hypercapnia and Eegsupporting

confidence: 82%

“…Indeed, in our study, IBIs decrease with increased CGA (17). In our study, RP Δ shows slight increase until 30 wk gestational age possibly due to the decrease in IBI Articles Victor et al…”

Section: Permissive Hypercapnia and Eegmentioning

confidence: 60%

Effect of permissive hypercapnia on background cerebral electrical activity in premature babies

et al. 2014

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“…Several studies have shown that the duration of EEG bursts increase with gestational age and that IBI decrease with increasing gestational age in preterm infants 5 . This seems to be relevant also for the most immature infants, as shown by a study of 15 infants with EEG's recorded at 21 to 26 weeks postconceptional age 6 .…”

Section: Introductionmentioning

confidence: 99%

Electroencephalography and brain damage in preterm infants

Hellström‐Westas

Rosén

2005

Early Human Development

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Electroencephalography (EEG) is a sensitive method for detection of brain injury in preterm infants. Although the acute and chronic EEG changes are mainly non-specific regarding type of injury, they correlate with later neurological and cognitive function. In infants developing periventricular hemorrhagic or ischemic brain injury, acute EEG findings include depression of background activity and presence of epileptic seizure activity. The chronic EEG changes associated with white matter injury and abnormal neurological development include delayed maturation, and presence of abundant rolandic sharp waves. Suboptimal cognitive development in preterm infants has been associated with changes in various sleep measures in EEG's recorded at full term. Continuous EEG-monitoring during neonatal intensive careshows that cerebral electrical activity during this vulnerable period can be affected by several extracerebral factors, e.g. cerebral blood flow, acidosis and some commonly used medications. For diagnosis of brain injury in preterm infants with neurophysiological methods, a combination of early continuous EEG monitoring during the initial intensive care period and full EEG, performed at later stages, is probably optimal.Key words: EEG, aEEG, Cerebral Function Monitor, preterm, brain injuryThe normal EEG of the very preterm infantOur knowledge about what can be considered as a normal early postnatal EEG in an extremely preterm infant has increased considerably during the last few years. Such studies of extremely preterm infants are methodologically difficult to perform, not least due to the vulnerability of these infants during the first days of life, and the study populations are consequently relatively small. Nevertheless, a few studies have managed to include very immature infants with no intracranial pathology on cranial ultrasound or magnetic resonance imaging and with normal long-term follow up. Postconceptional age (PCA) is a commonly used term in EEG studies for describing the infant's degree of maturation. It is often defined as gestational age (GA) in weeks at delivery plus postnatal age in weeks. However, some authors use other terms, e.g. conceptional age and postmenstrual age. In this review we have chosen to use the authors' own terminology regarding the infant's maturity. Extrauterine life is not a normal condition in preterm infants, and therefore data on "normal" postnatal development of EEG in extremely preterm infants is lacking. Serial EEG's of preterm infants without brain lesions and who developed normally give the closest approximation of normal EEG development. However, some studies from healthy preterm infants indicate that some features of the EEG, especially regarding sleep-state variables, at full-term may differ from the EEG's of newborns born at normal gestations 1,2 . Magnetoencephalography (MEG) is an advanced non-invasive method that can be performed on normal intrauterine fetuses. It is likely that MEG-data in the future can add knowledge on the normal neurophysiological develo...

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“…6,24,25 Similarly, the interburst interval, a surrogate measure of EEG discontinuity, was reported to decrease as GA increases. 5,6,24,25 Interestingly, in the present study, periods of continuous aEEG activity were found in preterm infants as early as 23 weeks of gestation.…”

Section: E64mentioning

confidence: 99%

“…Further, data on normal EEG patterns in extremely premature infants are still limited. 5,6 Recently, amplitude-integrated EEG (aEEG) provided by the cerebral function monitor (CFM), 7 a single-channel, time-compressed aEEG monitor, has gained widespread popularity as an alternative to conventional EEG monitoring in neonates. aEEG circumvents most of the problems of conventional EEG in this age group by generation of a compressed curve allowing continuous point-of-care monitoring for hours and a relative ease of application and interpretation.…”

mentioning

confidence: 99%

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

et al. 2004

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ABSTRACT. Objective. To prospectively investigate the development of amplitude-integrated electroencephalographic (aEEG) activity during the first 2 weeks of life in neurologically normal and clinically stable preterm infants <30 weeks' gestational age (GA).Patients and Methods. Infants with a GA of <30 weeks admitted to the neonatal intensive care unit of the Vienna University Children's Hospital (Vienna, Austria) were studied prospectively by using aEEG and cranial ultrasound. Clinically stable infants without clinical or sonographic evidence of neurologic abnormalities were eligible for inclusion in the reference group. The distribution of 3 background aEEG activity patterns (discontinuous low-voltage, discontinuous high-voltage, and continuous), presence of sleep-wake cycles, and number of bursts per hour in the reference group were determined by visual analysis.Results. Seventy-five infants (median GA: 27 weeks; range: 23-29 weeks) were eligible for inclusion in the reference group and had aEEG recordings during the first 2 weeks of life available. Analysis of aEEG background activity showed that with higher GA the relative amount of continuous activity increased while discontinuous patterns decreased. The number of bursts per hour decreased with increasing GA. Cyclical changes in aEEG background activity resembling early sleep-wake cycles were observed in all infants.Conclusions. Normal values for aEEG background activity were determined in preterm infants <30 weeks' GA. Clinically stable and neurologically normal preterm infants exhibit at least 2 different patterns of aEEG activity. There is a correlation between the GA and the relative duration of continuous aEEG activity. A dvances in neonatal intensive care during the last decades have led to an increased survival rate of extremely low birth weight infants. However, neurologic and developmental disability is still common among survivors. 1 Prevention of brain injury in these patients has become one of the main goals of modern neonatology. Continuous monitoring of neonatal brain function may aid in the identification of risk factors and patients at increased risk for neurologic morbidity. Early recognition and modification of potentially harmful environmental factors may prevent secondary brain injury.Conventional electroencephalography (EEG) is one of the most useful tools for intermittent and continuous assessment of brain function and prediction of neurologic outcome in term infants and children. 2-4 However, conventional EEG has limitations in its application for extremely low birth weight infants. Registration and interpretation of conventional EEG in this age group are difficult because of the electrical interferences on the neonatal intensive care unit, the large volume of data generated during a longer recording, and the need for 24-hour availability of a skilled examiner experienced in EEG of preterm infants. Further, data on normal EEG patterns in extremely premature infants are still limited. 5,6 Recently, amplitude-integrated EEG (aEEG) pro...

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Background electroencephalographic (EEG) activities of very preterm infants born at less than 27 weeks gestation: a study on the degree of continuity

Cited by 92 publications

References 23 publications

Effect of permissive hypercapnia on background cerebral electrical activity in premature babies

Effect of permissive hypercapnia on background cerebral electrical activity in premature babies

Electroencephalography and brain damage in preterm infants

Reference Values for Amplitude-Integrated Electroencephalographic Activity in Preterm Infants Younger Than 30 Weeks’ Gestational Age

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