Comparison Between Simultaneously Recorded Amplitude Integrated Electroencephalogram (Cerebral Function Monitor) and Standard Electroencephalogram in Neonates

Toet, Mona C.; Meij, W. van der; Vries, Linda S. de; Uiterwaal, Cuno S.P.M.; Huffelen, Kees C van

doi:10.1542/peds.109.5.772

Cited by 277 publications

(165 citation statements)

References 14 publications

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“…Several studies examined the utility of aEEG in comparison with conventional and/or video-EEG in this infant population, finding that aEEG was not only reliable but also complemented cEEG in more than one aspect. 14,26 A recent pilot study on the feasibility of aEEG in our tertiary-care NICU showed that 73% of seizures >30 s and 87% >60 s were detected by the aEEG seizure algorithm. 27 Furthermore, when compared with a blinded study group, patients whose tracings were visible to bedside physicians showed a trend toward reduced seizure burden without evidence of overtreatment.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, Hellström-Westas et al 13 used pattern recognition as well as voltage criteria to describe aEEG patterns in term and preterm infants. This method, not unlike that used by Toet et al, 14 uses cEEG terminology (for example, burst suppression, isoelectric tracing, trace alternant). The background pattern is continuous, discontinuous, burst suppression, continuous low voltage or flat/ isoelectric, and specific voltage criteria are used as well (Figure 3).…”

Section: Introductionmentioning

confidence: 99%

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Using amplitude-integrated EEG in neonatal intensive care

Tao

Mathur

2010

J Perinatol

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The implementation of amplitude-integrated electroencephalography (aEEG) has enhanced the neurological monitoring of critically ill infants. Limited channel leads are applied to the patient and data are displayed in a semilogarithmic, time-compressed scale. Several classifications are currently in use to describe patient tracings, incorporating voltage criteria, pattern recognition, cyclicity, and the presence or absence of seizures. In term neonates, aEEG has been used to determine the prognosis and treatment for those affected by hypoxic-ischemic encephalopathy, seizures, meningitis and even congenital heart disease. Its application as inclusion criteria for therapeutic hypothermia remains controversial. In preterm infants, normative values and patterns corresponding to gestational age are being established. As these standards emerge, the predictive value of aEEG increases, especially in the setting of preterm brain injury and intraventricular hemorrhage. The sensitivity and specificity of aEEG are enhanced by the display of a simultaneous raw EEG, which aids interpretation. Caution must be taken when using and interpreting this tool in conjunction with certain medications and in the setting of less experienced staff. Continuing efforts at developing software that can aid seizure detection and background classification will enhance the bedside utility of this tool.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using amplitude-integrated EEG in neonatal intensive care

Tao

Mathur

2010

J Perinatol

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“…It provides an index of cerebral background activity and correlates with the background pattern of a full EEG (11). Premature infants undergoing serial aEEG recordings after birth demonstrate maturational changes characterized by increasing frequency of cycles (derived from repetitive changes between continuous and discontinuous EEG activity), decreasing discontinuity and a narrowing of the span (12).…”

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confidence: 99%

Neurological maturation of late preterm infants at 34 wk assessed by amplitude integrated electroencephalogram

et al. 2013

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Background: This study tested if measures of central nervous system (CNS) immaturity reflected by amplitude integrated electroencephalogram (aEEG) and associated clinical morbidities are determinants of length of hospitalization among late preterm infants born at 34 wk. Methods: This was a prospective cohort study of infants with a gestational age of 34 wk 0-6 d who had a single aEEG recording acquired over 6 h in a neonatal intensive care unit within 72 h of birth (n = 80). Infants were followed for predefined morbidities (classified as CNS or non-CNS) and length of hospitalization (determined by the clinical care team). aEEG variables were correlated with length of hospitalization. results: Eighty infants were enrolled and 75 aEEG recordings were analyzed. The average length of hospitalization was 10.4 ± 7.2 d (range 3-46 d). The total number of cycles recorded in the first 72 h following birth were inversely correlated with the length of hospitalization (r 2 = 0.44, P < 0.001). Kaplan-Meier curves indicated that morbidities consistent with neurological immaturity were associated with a longer length of hospitalization (P < 0.001). conclusion: Neurological maturation as indicated by aEEG and specific clinical morbidities is an important determinant of length of hospitalization among late-preterm infants.

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“…Several studies have demonstrated that aEEG is easier to be interpreted than standard EEG, but equally accurate and reproducible [23]. It correlates well with neurodevelopmental outcome of full-term infants with HIE [13,24,25], and it is considered the best single predictor of neurologic outcome [26].…”

Section: Discussionmentioning

confidence: 99%

Hypothermia for neonatal hypoxic-ischemic encephalopathy: may an early amplitude-integrated EEG improve the selection of candidates for cooling?

Filippi¹,

Catarzi²,

Gozzini³

et al. 2012

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective: To report our experience in the selection of newborns candidate to therapeutic hypothermia. Methods: Retrospective study involving 47 newborns suffering from perinatal asphyxia from January 2008 to September 2011. Results: Thirty-five of 47 newborns admitted to our hospital fulfilled metabolic and neurological criteria for recruitment and were cooled. aEEG was carried out in 26 of them and resulted always abnormal. In three of the 12 newborns with only metabolic criteria, aEEG was moderately abnormal. They were cooled and their outcome (evaluated by General Movements and Griffiths Mental Development Scales for children aged 0-2 years) is good. Three additional newborns who only met the metabolic criterion reached our hospital after the therapeutic window for hypothermia and exhibited seizures; their outcome is poor. Conclusions: In our experience, the inclusion of aEEG in the entry criteria would not have precluded newborns with neurological criteria from cooling. On the contrary, without an early aEEG, we would have excluded from hypothermia infants with moderate hypoxic-ischemic encephalopathy without precocious neurological signs who exhibited only the metabolic criterion, but with abnormal aEEG. If further studies will confirm that early aEEG might identify newborns suitable for cooling even in the absence of clinical signs, a revision of the entry criteria should be considered.

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Comparison Between Simultaneously Recorded Amplitude Integrated Electroencephalogram (Cerebral Function Monitor) and Standard Electroencephalogram in Neonates

Cited by 277 publications

References 14 publications

Using amplitude-integrated EEG in neonatal intensive care

Using amplitude-integrated EEG in neonatal intensive care

Neurological maturation of late preterm infants at 34 wk assessed by amplitude integrated electroencephalogram

Hypothermia for neonatal hypoxic-ischemic encephalopathy: may an early amplitude-integrated EEG improve the selection of candidates for cooling?

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