Longitudinal Analysis of Amplitude-Integrated Electroencephalography for Outcome Prediction in Hypoxic-Ischemic Encephalopathy

Méder, Ünőke; Csekő, Anna; Szakacs, Laszlo; Balogh, Csenge D.; Szakmár, Enikő; Andorka, Csilla; Kovacs, Kata; Dobi, Marianna; Brandt, F. A.; Szabó, Miklós; Szabó, Attila; Jermendy, Ágnes

doi:10.1016/j.jpeds.2022.04.013

Cited by 7 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At 36 hours, the OR for abnormal background activity on aEEG to predict poor outcomes was 10.7 (95% CI: 1.9-59.6, p = 0.007) [13]. Meder et al also confirmed the predictive value of longitudinal analysis of aEEG background with an AUC of 0.90 (95% CI: 0.85-0.95) in an observational study including 149 neonates with HIE [14]. An outcome predictive tool based on the results of this study was built, named the HIE Outcome Prediction using aEEG, HOPE, and is available openly for neonatal institutions.…”

Section: Discussionmentioning

confidence: 89%

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

Hua,

Nguyen,

Nguyen

2024

Cureus

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 89%

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

Hua,

Nguyen,

Nguyen

2024

Cureus

View full text Add to dashboard Cite

“…0.19 mg/kg and 0.43 mg/kg respectively [73]. On the contrary, Meder et al reported a significant difference in cumulative morphine doses at 84 hours between neonates with favourable outcomes [850 (760-990) μg] and abnormal outcomes [740 (380-740)μg] [74]. Gundersen et al concluded that the cumulative dose of opioids administered during TH [median 2121 μg/kg] in the prospectively collected population cohort had no significant association with any of the domains of early childhood development [38].…”

Section: Short-term Outcome (Clinical)mentioning

confidence: 99%

Analgesia and sedation strategies in neonates undergoing whole-body therapeutic hypothermia: A scoping review

Joshi,

Muneer,

Mbuagbaw

et al. 2023

PLoS ONE

View full text Add to dashboard Cite

Background Therapeutic hypothermia (TH) is a widely practiced neuroprotective strategy for neonates with hypoxic-ischemic encephalopathy. Induced hypothermia is associated with shivering, cold pain, agitation, and distress. Objective This scoping review determines the breadth of research undertaken for pain and stress management in neonates undergoing hypothermia therapy, the pharmacokinetics of analgesic and sedative medications during hypothermia and the effect of such medication on short- and long-term neurological outcomes. Methods We searched the following online databases namely, (i) MEDLINE, (ii) Web of Science, (iii) Cochrane Library, (iv) Scopus, (v) CINAHL, and (vi) EMBASE to identify published original articles between January 2005 and December 2022. We included only English full-text articles on neonates treated with TH and reported the sedation/analgesia strategy used. We excluded articles that reported TH on transport or extracorporeal membrane oxygenation, did not report the intervention strategies for sedation/analgesia, and reported hypoxic-ischemic encephalopathy in which hypothermia was not applied. Results The eligible publications (n = 97) included cohort studies (n = 72), non-randomized experimental studies (n = 2), pharmacokinetic studies (n = 4), dose escalation feasibility trial (n = 1), cross-sectional surveys (n = 5), and randomized control trials (n = 13). Neonatal Pain, Agitation, and Sedation Scale (NPASS) is the most frequently used pain assessment tool in this cohort. The most frequently used pharmacological agents are opioids (Morphine, Fentanyl), benzodiazepine (Midazolam) and Alpha2 agonists (Dexmedetomidine). The proportion of neonates receiving routine sedation-analgesia during TH is center-specific and varies from 40–100% worldwide. TH alters most drugs’ metabolic rate and clearance, except for Midazolam. Dexmedetomidine has additional benefits of thermal tolerance, neuroprotection, faster recovery, and less likelihood of seizures. There is a wide inter-individual variability in serum drug levels due to the impact of temperature, end-organ dysfunction, postnatal age, and body weight on drug metabolism. Conclusions No multidimensional pain scale has been tested for reliability and construct validity in hypothermic encephalopathic neonates. There is an increasing trend towards using routine sedation/analgesia during TH worldwide. Wide variability in the type of medication used, administration (bolus versus infusion), and dose ranges used emphasizes the urgent need for standardized practice recommendations and guidelines. There is insufficient data on the long-term neurological outcomes of exposure to these medications, adjusted for underlying brain injury and severity of encephalopathy. Future studies will need to develop framework tools to enable precise control of sedation/analgesia drug exposure customized to individual patient needs.

show abstract

Sleep State Trend (SST), a bedside measure of neonatal sleep state fluctuations based on single EEG channels

Moghadam

Nevalainen

Stevenson

et al. 2022

Clinical Neurophysiology

View full text Add to dashboard Cite

Longitudinal Analysis of Amplitude-Integrated Electroencephalography for Outcome Prediction in Hypoxic-Ischemic Encephalopathy

Cited by 7 publications

References 25 publications

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

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

Analgesia and sedation strategies in neonates undergoing whole-body therapeutic hypothermia: A scoping review

Sleep State Trend (SST), a bedside measure of neonatal sleep state fluctuations based on single EEG channels

Contact Info

Product

Resources

About