Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury ,

Jornal de Pediatria

Paulina A. Toso¹  Alvaro J. González¹  María E. Pérez¹  Javier Kattan¹  Jorge G. Fabres¹  José L. Tapia¹  Hernán S. González¹ 

关键词: Amplitude integrated electroencephalography (aEEG);    Hypoxic ischemic encephalopathy (HIE);    Neonatal intensive care;    Seizures;    Eletroencefalo- gramade amplitude integrada (aEEG);    Encefalopatia hipóxico-isquêmica (EHI);    Terapia intensiva neonatal;    Convulsões;   

DOI  :  10.1016/j.jped.2013.07.004

来源: SciELO

【 摘 要 】

OBJECTIVE:to test the clinical utility of an early amplitude-integrated electroencephalography (aEEG) to predict short-term neurological outcome in term newborns at risk of neurology injury.METHODS:this was a prospective, descriptive study. The inclusion criteria were neonatal encephalopathy, neurologic disturbances, and severe respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values, and likelihood ratio (LR) were calculated. Clinical and demographic data were analyzed. Neurological outcome was defined as the sum of clinical, electroimaging, and neuroimaging findings.RESULTS:ten of the 21 monitored infants (48%) presented altered short-term neurologic outcome. The aEEG had 90% sensitivity, 82% specificity, 82% positive predictive value, and 90% negative predictive value. The positive LR was 4.95, and the negative LR was 0.12. In three of 12 (25%) encephalopathic infants, the aEEG allowed for a better definition of the severity of their condition. Seizures were detected in eight infants (38%), all subclinical at baseline, and none had a normal aEEG background pattern. The status of three infants (43%) evolved and required two or more drugs for treatment.CONCLUSIONS:in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detected early subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurological outcomes for all sick newborn.

【 授权许可】

CC BY-NC-ND   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License