Statistics

 array:24 [
  "pii" => "S2341287921001587"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2020.09.010"
  "estado" => "S300"
  "fechaPublicacion" => "2021-12-01"
  "aid" => "2980"
  "copyrightAnyo" => "2021"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "An Pediatr (Barc). 2021;95:423-30"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S1695403320304252"
      "issn" => "16954033"
      "doi" => "10.1016/j.anpedi.2020.09.009"
      "estado" => "S300"
      "fechaPublicacion" => "2021-12-01"
      "aid" => "2980"
      "copyright" => "Asociación Española de Pediatría"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "fla"
      "cita" => "An Pediatr (Barc). 2021;95:423-30"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>"
        "titulo" => "Evaluaci&#243;n de la idoneidad y aplicabilidad cl&#237;nica de diferentes electrodos para la monitorizaci&#243;n aEEG&#47;cEEG en el ni&#241;o prematuro extremo"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "423"
            "paginaFinal" => "430"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Evaluation of the suitability and clinical applicability of different electrodes for aEEG&#47;cEEG monitoring in the extremely premature infant"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 404
                "Ancho" => 1500
                "Tamanyo" => 47900
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Electrodos autoadhesivos con gel l&#237;quido conductor con y sin cable integrado&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Malaika Cordeiro, Helena Peinado, Mar&#237;a Teresa Montes, Eva Valverde"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Malaika"
                "apellidos" => "Cordeiro"
              ]
              1 => array:2 [
                "nombre" => "Helena"
                "apellidos" => "Peinado"
              ]
              2 => array:2 [
                "nombre" => "Mar&#237;a Teresa"
                "apellidos" => "Montes"
              ]
              3 => array:2 [
                "nombre" => "Eva"
                "apellidos" => "Valverde"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2341287921001587"
          "doi" => "10.1016/j.anpede.2020.09.010"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287921001587?idApp=UINPBA00005H"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320304252?idApp=UINPBA00005H"
      "url" => "/16954033/0000009500000006/v2_202112240557/S1695403320304252/v2_202112240557/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2341287921001794"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2020.10.010"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "3001"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2021;95:431-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Antibiotic resistances and eradication rates in <span class="elsevierStyleItalic">Helicobacter pylori</span> infection"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "431"
          "paginaFinal" => "437"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Resistencias antibi&#243;ticas y tasas de erradicaci&#243;n en infecci&#243;n por <span class="elsevierStyleItalic">Helicobacter pylori</span>"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 924
              "Ancho" => 2199
              "Tamanyo" => 104805
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Temporal trends in antimicrobial resistance&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Gonzalo Botija, Clara Garc&#237;a Rodr&#237;guez, Ar&#225;nzazu Recio Linares, Carolina Campelo Guti&#233;rrez, Elia P&#233;rez-Fern&#225;ndez, Alfonso Barrio Merino"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Gonzalo"
              "apellidos" => "Botija"
            ]
            1 => array:2 [
              "nombre" => "Clara"
              "apellidos" => "Garc&#237;a Rodr&#237;guez"
            ]
            2 => array:2 [
              "nombre" => "Ar&#225;nzazu"
              "apellidos" => "Recio Linares"
            ]
            3 => array:2 [
              "nombre" => "Carolina"
              "apellidos" => "Campelo Guti&#233;rrez"
            ]
            4 => array:2 [
              "nombre" => "Elia"
              "apellidos" => "P&#233;rez-Fern&#225;ndez"
            ]
            5 => array:2 [
              "nombre" => "Alfonso"
              "apellidos" => "Barrio Merino"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403320304483"
        "doi" => "10.1016/j.anpedi.2020.10.006"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320304483?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287921001794?idApp=UINPBA00005H"
    "url" => "/23412879/0000009500000006/v2_202112161235/S2341287921001794/v2_202112161235/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2341287921001824"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2020.10.011"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "3006"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2021;95:413-22"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "The informed consent in the mature minor&#58; Understanding and decision-making capacity"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "413"
          "paginaFinal" => "422"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "El consentimiento informado en el menor maduro&#58; comprensi&#243;n y capacidad de decisi&#243;n"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1898
              "Ancho" => 3333
              "Tamanyo" => 591048
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flowchart of article selection process&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Reyes Boceta, Olga Mart&#237;nez-Casares, Marta Albert"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Reyes"
              "apellidos" => "Boceta"
            ]
            1 => array:2 [
              "nombre" => "Olga"
              "apellidos" => "Mart&#237;nez-Casares"
            ]
            2 => array:2 [
              "nombre" => "Marta"
              "apellidos" => "Albert"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403320304537"
        "doi" => "10.1016/j.anpedi.2020.10.011"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403320304537?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287921001824?idApp=UINPBA00005H"
    "url" => "/23412879/0000009500000006/v2_202112161235/S2341287921001824/v2_202112161235/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Evaluation of the suitability and clinical applicability of different electrodes for aEEG&#47;cEEG monitoring in the extremely premature infant"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "423"
        "paginaFinal" => "430"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Malaika Cordeiro, Helena Peinado, Mar&#237;a Teresa Montes, Eva Valverde"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Malaika"
            "apellidos" => "Cordeiro"
            "email" => array:1 [
              0 => "malaika.cordeiro@salud.madrid.org"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Helena"
            "apellidos" => "Peinado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Mar&#237;a Teresa"
            "apellidos" => "Montes"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Eva"
            "apellidos" => "Valverde"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Neonatolog&#237;a&#44; Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Fundaci&#243;n NeNe&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Evaluaci&#243;n de la idoneidad y aplicabilidad cl&#237;nica de diferentes electrodos para la monitorizaci&#243;n aEEG&#47;cEEG en el ni&#241;o prematuro extremo"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2300
            "Ancho" => 3167
            "Tamanyo" => 537234
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Evaluation of the different types of electrodes used in our neonatal unit&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The applicability of continuous cerebral function monitoring by amplitude integrated electroencephalography &#40;aEEG&#41; in neonatal clinical practice is indisputable&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> The indications for its use in term neonates are well established&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> When it comes to preterm infants&#44; recent studies have demonstrated its usefulness to detect acute brain injury&#44; assess the maturation of cerebral electrical activity and to predict neurologic outcomes&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;20</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The difficulty in correctly placing electrodes frequently delays initiation of monitoring&#44; creates artefacts in the tracings that hinder their interpretation and&#47;or results in multiple handlings of unstable patients&#46; These hurdles are magnified in extremely preterm infants&#44; especially in the first few days of life&#44; discouraging neuromonitoring&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> The room available for manoeuvring is very limited&#44; as these infants need to be in the incubator and frequently ventilatory support as well&#46; The surface available to place the electrodes is also limited due to the small size of the head&#44; and difficult to access since most of these infants require tight caps to hold nasal continuous positive airway pressure &#40;nCPAP&#41; devices&#46; Time is another limitation&#44; as loss of heat and humidity during prolonged handling could disrupt the thermal homeostasis of the infant and&#44; in the most vulnerable patients&#44; haemodynamic instability&#46; Thus&#44; despite it being a non-invasive technique&#44; initiating aEEG monitoring requires considerable skill&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of our study was to analyse the different electrodes available for neurologic monitoring with aEEG or continuous electroencephalography &#40;cEEG&#41;&#44; select the type best suited to the particular characteristics of extremely preterm infants and assess its usefulness in clinical practice&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted the study in a level IIIC neonatal unit equipped with cerebral function monitors since 2006&#46; Different types of electrodes have been used from the time aEEG monitoring was introduced in the unit&#58; subdermal needles &#40;Ambu&#174; Neuroline Subdermal Needle&#41;&#44; silver cups &#40;Pediatric Silver Cup Electrodes&#44; Natus&#174; Neurology&#41;&#44; solid hydrogel self-adhesive electrodes &#40;Neonatal Hydrogel Sensors&#44; Natus&#174; Neurology and Ambu&#174; Neuroline 700&#41; and wet gel self-adhesive electrodes&#44; with a pre-attached lead wire &#40;Ambu&#174; Neuroline 720&#41; and without &#40;Ambu&#174; BlueSensor N&#44; used with Natus&#174; Neurology reusable snap leads&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With the aim of designing a study protocol to analyse continuous neurologic monitoring in preterm infants delivered before 28 weeks&#8217; gestation&#44; we reviewed the experience of our unit with the use of the different types of electrodes available for aEEG&#47;cEEG monitoring&#46; Two neonatologists with expertise in aEEG monitoring carried out the assessment&#46; The analysis was based in their own experience using the different electrodes in clinical practice and a survey of teaching nurses and nurses with more than 10 years&#8217; experience in the unit&#46; We assessed the need for prior preparation of the scalp to achieve an adequate impedance&#44; the time required for electrode placement&#44; whether the placement technique was invasive or not&#44; whether it was possible to reposition the electrodes&#44; the risk of cutaneous lesions in case of prolonged monitoring and the sterility and durability of electrodes&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The electrode that was eventually selected&#44; a self-adhesive wet gel electrode with a pre-attached lead wire &#40;Ambu&#174; Neuroline 720&#41;&#44; was used for cEEG monitoring in preterm infants delivered before 28 weeks&#8217; gestation&#44; initiated in the first 24&#8239;h post birth and maintained at least through 72&#8239;h&#46; We used the modified International 10&#47;20 montage model &#40;10 electrodes&#47;patient&#58; Fp1&#44; Fp2&#44; C3&#44; C4&#44; T3&#44; T4&#44; O1&#44; O2&#44; ground and reference&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> The aEEG trend was derived from 3 channels &#40;C3-T3&#44; C4-T4&#44; C3-C4&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Electrode placement procedure</span><p id="par0035" class="elsevierStylePara elsevierViewall">To minimise the time spent handling the patient and working inside the incubator and ensure uniform implementation of the procedure&#44; we followed the steps proposed by Lloyd et al<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> with some modifications&#58; &#40;1&#41; label the electrodes at both ends with the corresponding anatomical sites&#58; with marker in the back of the sensor end and with a label in the wire&#44; close to the connector to the EEG amplifier&#44; so that the electrodes can be connected to the headbox at a later time&#59; &#40;2&#41; Group all the cables in a substantial length of tubular stockinette &#40;Tubinet&#174;&#41; to prevent entanglement with other cables&#44; infusion lines or tubing and reduce interference&#59; &#40;3&#41; Group the electrodes of each hemisphere together to apply the electrodes to one side of the head and then the other&#44; thus reducing head turning<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The electrodes were introduced in the incubator a few minutes before placement to warm them up and facilitate adhesion&#46; Then&#44; the protective plastic lining was removed from the electrodes followed by application of an amount of conductive adhesive gel the size of a rice grain &#40;P&#226;te ReegaPha Conductrice Tube&#44; MEI&#41;&#46; After placing each electrode in the corresponding site&#44; pressure was exerted for a few seconds along its edges &#40;as opposed to the area containing the sensor and gel&#41; to achieve maximum adhesion&#46; Patients that did not need a nCPAP cap were fitted with a cap made with a tubular net bandage &#40;Tubifix&#174;&#41; to hold the electrodes&#46; Monitoring was performed with the NicoletOne&#8482; EEG System &#40;Natus Medical Inc&#46;&#44; USA&#41;&#46; We also used a questionnaire regarding the parameters used in the initial selection of the optimal electrode&#44; surveying the satisfaction of the nursing staff involved in the placement and maintenance of the electrodes used in the patients under study&#46; Electrodes were removed with a cleaning solution &#40;Brava&#174; adhesive remover spray&#44; Coloplast&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The study was approved by the Clinical Research Ethics Committee&#46; We included patients in the study after obtaining signed informed consent&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">We present quantitative data as mean&#8239;&#177;&#8239;standard deviation&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Analysis of the pros and cons of the different types of electrodes</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ambu&#174; Neuroline Subdermal Needle</span><p id="par0055" class="elsevierStylePara elsevierViewall">Does not require previous preparation of the scalp save for the application of antiseptic and can be placed quickly&#46; The drawback is that placement is invasive&#44; breaking the skin barrier and thereby posing a risk of cutaneous lesions and infection&#46; They allow prolonged monitoring&#44; although they get displaced relatively frequently&#44; requiring readjustment&#46; They pose a risk of accidental needle stick injury in health care workers&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Pediatric Silver Cup Electrodes&#44; Natus&#174; Neurology</span><p id="par0060" class="elsevierStylePara elsevierViewall">Placement is non-invasive and can be repeated as many times as needed&#44; and the electrodes are the smallest available &#40;6&#8239;mm cup diameter&#41;&#46; The drawback is that placement takes time&#44; as the scalp must be prepared with an abrasive paste and each cup must be filled with conductive paste and taped to the scalp to achieve adequate fixation&#46; They also get displaced often&#44; are associated with a risk of skin lesions in lying positions and are not disposable&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Self-adhesive pre-gelled solid Hydrogel electrodes &#40;Neonatal Hydrogel Sensors&#44; Natus&#174; Neurology and Ambu&#174; Neuroline 700&#41;</span><p id="par0065" class="elsevierStylePara elsevierViewall">These electrodes are flat and have a silver sensor that sits on a flexible layer of conductive and adhesive hydrogel that facilitates repositioning&#46; Thus&#44; the area of skin in contact with the electrode corresponds to the area of adhesion and measurement&#46; The smallest electrodes in this category are manufactured by Ambu&#174; &#40;15&#8239;&#215;&#8239;20&#8239;mm&#41;&#46; Placement is quick and non-invasive&#44; removal is easy&#44; leaving no residue on the skin&#44; and they are disposable&#46; However&#44; they require preparation of the scalp with an abrasive paste and&#44; in our experience&#44; they do not stay fixed long and frequently lose adequate contact with the scalp&#44; requiring frequent reattachment&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Self-adhesive pre-gelled wet gel electrodes with pre-attached lead wire &#40;Ambu&#174; Neuroline 720&#41; and without pre-attached wire &#40;Ambu&#174; BlueSensor N used with Natus&#174; Neurology reusable snap leads&#41;</span><p id="par0070" class="elsevierStylePara elsevierViewall">They have a silver sensor that sits on a small sponge soaked in wet conductive gel and surrounded by an adhesive acrylic tab &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Thus&#44; in these electrodes&#44; the measurement area is smaller than the area of contact with the skin and separate from the adhesion area&#46; They do not require preparation of the scalp and can be placed quickly and non-invasively&#44; the adhesion of the acrylate is strong and lasting&#44; and the gel has a high conductivity&#46; In prolonged recordings&#44; the contact of the sensor with the scalp deteriorates as the conductive gel dries up&#44; but this can be fixed without detaching the electrode by applying an adhesive conductive gel between the electrode tab and the scalp&#46; However&#44; if the electrode detaches completely from the scalp&#44; it can no longer adhere to the skin and cannot be reused&#46; Removal of the electrodes and&#44; if used&#44; any added adhesive conductive gel that has dried up&#44; may require an adhesive removal spray&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The model with the pre-attached lead wire is flat &#40;30&#8239;&#215;&#8239;22&#8239;mm&#41; and fully disposable&#46; The model without the pre-attached lead wire is larger &#40;44&#46;8&#8239;&#215;&#8239;22&#8239;mm&#41; because it includes the connector for the wire&#44; which&#44; in turn&#44; has the disadvantage of creating bulk where it attaches to the electrode and is not disposable&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Selection of the optimal electrode</span><p id="par0080" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> presents the comparison of the different electrodes based on the parameters selected to determine their ease of use and appropriateness by 2 neonatologists experienced in EEG monitoring and the nurses of the neonatal intensive care unit&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Applicability to clinical practice</span><p id="par0085" class="elsevierStylePara elsevierViewall">We used self-adhesive wet gel electrodes with pre-attached lead wires &#40;Ambu&#174; Neuroline 720&#41; in 41 infants born at a mean gestational age of 25&#46;8&#8239;&#177;&#8239;1&#46;1 weeks with a mean weight of 820&#8239;&#177;&#8239;186&#8239;g&#46; The mean total time elapsed in preparation and electrode placement to initiation of monitoring was 30&#8239;min&#46; An impedance of less than 10&#8239;k&#937; in every electrode was achieved in the first in 36 patients &#40;88&#37;&#41;&#44; with an impedance of less than 5&#8239;k&#937; in every electrode in 25 patients &#40;61&#37;&#41;&#46; The mean duration of aEEG&#47;cEEG monitoring was 71&#8239;&#177;&#8239;17&#8239;h&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">During monitoring&#44; we made 375 measurements of impedance&#58; the impedance was less than 10&#8239;k&#937; in all electrodes in 286 tests &#40;76&#37;&#41; and less than 5&#8239;k&#937; in every electrode in 195 tests &#40;52&#37;&#41;&#46; The electrodes did not have to be changed in any patient&#46; The application of a small amount of adhesive conductive gel &#40;Pate ReegaPha Conductrice Tube&#44; MEI&#41; under the self-adhesive disc with a plastic cannula connected to a syringe loaded with the gel sufficed to lower the impedance whenever the contact of a sensor with the scalp deteriorated&#46; Cutaneous lesions were not detected in any patient&#46; The staff involved in electrode placement and maintenance reported a high level of satisfaction&#46; Electrodes were removed easily with the adhesive removal spray &#40;Brava&#174;&#44; Coloplast&#41;&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">This study outlines a systematic&#44; simple&#44; non-invasive and lasting method to place electrodes for continuous monitoring by aEEG&#47;cEEG in extremely preterm infants&#46; We tackled 2 challenges&#58; &#40;1&#41; identifying the optimal electrodes for this subset of preterm infants&#44; prioritising the minimization of invasiveness and handling both in the placement and the maintenance of the electrodes&#44; and &#40;2&#41; being able to carry out prolonged monitoring while maintaining low impedance values and obtaining quality recordings&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The main foe we faced was impedance&#44; and we prevailed&#46; Impedance in this context is defined as the opposition to the passage of electric current between the surface of the cerebral cortex and the scalp&#44; and when it comes to surface electrodes&#44; it reflects the quality of the contact between the skin and the electrode&#46; A high impedance in an electrode increases the likelihood that it will register other signals commonly found in the environment &#40;respirators&#44; infusion pumps&#44; lights&#41;&#44; creating artefacts in the recording&#46; Subdermal needles achieve a low and stable impedance immediately without the need to exfoliate the skin&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> However&#44; this method is not perceived positively by health care staff or families on account of its invasiveness&#46; The American Clinical Neurophysiology Society<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> consider its use contraindicated&#46; The alternative to needles is the laborious preparation of the scalp with an abrasive paste or gel to use surface electrodes &#40;self-adhesive and cup electrodes&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;28</span></a> This exfoliation removes the dry topmost layer of the epidermis and moistens the stratum corneum&#44; thereby improving conductivity&#44; but its use in extremely preterm newborns is discouraged due to the risk of cutaneous lesions&#46; With self-adhesive wet gel electrodes&#44; with the occasional application of a small amount of adhesive conductive gel&#44; it is possible to achieve impedances below 5&#8211;10&#8239;k&#937; without the use of the abrasive paste&#46; While impedances below 5&#8239;k&#937; are ideal&#44; neurophysiology standards allow for impedances below 10&#8239;k&#937;&#44; especially in neonates&#44; to avoid excessive handling and prevent cutaneous lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> In infants delivered before 30 weeks&#8217; gestation&#44; the epidermis is excessively hydrated and constitutes a poor barrier that matures quickly after from 1 week post birth&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> This could explain why low impedances can be achieved without needing to exfoliate the skin in this population&#46; However&#44; wet gel hydrates the skin more and quicker than hydrogel&#44; which also contributes to improving conductivity&#44; and the gel used in wet gel electrodes is highly conductive&#46; Thus&#44; the use of self-adhesive wet gel electrodes can decrease handling times and the potential discomfort caused by the preparation of the scalp&#44; in addition to achieving lower impedances and improving the quality of the signal&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">We prepared the electrodes following a process similar to the one described by Lloyd et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> which allowed reducing preparation time in the incubator and the number of times the infant&#8217;s head needed to be moved&#46; It is also very useful to have the electrodes labelled on the end of the cable near the EEG amplifier&#44; as it allows quick disconnections and reconnections in case&#44; for instance&#44; a cap needs to be placed on the infant due to accidental extubation for urgent switching to non-invasive ventilation with CPAP&#46; Lloyd et al&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> used solid hydrogel electrodes successfully&#46; In our experience&#44; hydrogel electrodes require frequent repositioning&#44; although we did not secure them with tape and conductive paste&#44; as the authors described&#46; In addition&#44; to maintain the electrodes in place and have easy access to them&#44; the authors used nCPAP caps cut along the anterior midline &#40;in patients with and without non-invasive ventilation&#41; that they then closed with the velcro that was part of the cap and adhesive tape&#46; They reported that this did not prevent the tight seal required for nCPAP&#44; but we do not think this is an adequate solution given the importance of the fit of the cap to keep the interface in the correct position&#46; Schumacher et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> also reported good results with the use of solid hydrogel electrodes using a holding cap similar to the one described by Lloyd et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> but specifically designed for the purpose&#46; The adhesiveness of wet gel electrodes is greater compared to hydrogel electrodes&#44; as the former use acrylate as an adhesive&#44; so they do not need an additional system to fix the electrodes&#44; such as adhesive tape&#44; although nCPAP caps or caps fashioned with tubular stockinette can also hold them in place by keeping the cables organized and preventing their displacement during handling&#46; On the other hand&#44; even if they are not accepted in the minimum technical standards&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> both methods<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;30</span></a> have been found to tolerate higher impedances &#40;20 and 40&#8239;k&#937;&#44; respectively&#41; based on the results of Ferree et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> who compared recordings obtained with impedances of 10 vs 40&#8239;k&#937; and found no significant differences&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Hydrogel electrodes and the adhesive tape used to hold cups and needles do not adhere well when there is hair on the scalp&#44; sometimes requiring shaving the area&#46; In such cases&#44; wet gel electrodes may also require preparation of the scalp to achieve an adequate impedance&#44; but the presence of hair does not diminish their ability to adhere&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The acrylic adhesive of the wet gel electrodes is therefore a great advantage when it comes to their placement&#44; but at the same time it is a drawback when it comes to their removal&#46; An adhesive removal spray is required to remove them without causing discomfort&#46; Once removed&#44; the electrodes can no longer adhere to the skin and therefore&#44; unlike the other types of electrodes&#44; cannot be reattached&#46; However&#44; also unlike the rest&#44; when the sensor is no longer making adequate contact with the scalp&#44; the problem can be resolved without removing the electrode to prepare the skin anew&#44; as adding a small amount of conductive gel under the adhesive disc is enough to restore contact&#46; We ought to emphasise the importance of applying very small amounts of gel under the sensors&#44; as excessive amounts may create electrical bridges between electrodes or create a crust upon drying that would act as a barrier and increase the impedance&#44; which would require changing the electrodes&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Whether the electrode has or not a pre-attached lead wire is a factor worth considering in preterm infants&#44; but is not considered important in our unit when it comes to term infants&#46; Due to the very small size of the head of preterm infants&#44; the additional space required by the press studs may interfere with the placement of CPAP caps&#44; add points of pressure on the skin frequently result in a poor fit of the stud and connector joint against the scalp&#44; which would instead be hanging and pulling on the electrode&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Although our study used conventional EEG monitoring&#44; aEEG monitoring&#44; that is&#44; monitoring with fewer electrodes&#44; is currently being used in clinical practice&#46; The system used in the study requires 3&#8211;6 electrodes per patient&#46; Nevertheless&#44; the time needed to initiate monitoring &#40;preparation&#44; opening incubator doors and handling patient&#41; would be shorter in everyday clinical practice in neonatal units&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">All the staff members involved in the placement and maintenance of the electrodes were clearly satisfied with them&#46; Many openly admitted that using this system and these electrodes they did not postpone or avoid initiation of neurologic monitoring&#44; and what used to be perceived as a tedious challenge is now approached with a proactive attitude in our unit&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The main limitation of this study is that we did not carry out a prospective and direct comparison of the different types of electrodes&#46; To date&#44; El Ters et al<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> have been the only authors to publish results of a prospective comparative study of electrodes&#46; They compared hydrogel and cup electrodes and found no difference in safety or the quality of the recordings&#46; In our experience&#44; self-adhesive wet gel electrodes offer higher conductivity and better adhesion compared to solid hydrogel electrodes&#44; allowing for longer monitoring and producing recordings of higher quality&#46; To date&#44; there are no studies in the literature analysing the use of self-adhesive wet gel electrodes in the neonatal population&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In future&#44; it would be useful to carry out a prospective study to compare solid hydrogel and self-adhesive wet gel electrodes&#46; In any case&#44; the future lies in dry sensor electrodes<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> integrated in caps designed to also be able to hold CPAP devices&#44; although there is still a long way to go&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusion</span><p id="par0145" class="elsevierStylePara elsevierViewall">Self-adhesive wet gel electrodes with pre-attached lead wires allow rapid and non-invasive electrode placement for prolonged&#44; high-quality aEEG&#47;cEEG monitoring in extremely preterm infants&#46; Overcoming the challenges of electrode placement will facilitate neuromonitoring in this population and improve the quality of care in neonatal intensive care units&#44; given the growing evidence that corroborates the clinical benefits of cerebral function monitoring by aEEG in preterm infants&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicts of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1630079"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Population and methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusion"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1454859"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1630080"
          "titulo" => "Resumen"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introducci&#243;n"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Poblaci&#243;n y m&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclusi&#243;n"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1454860"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Patients and methods"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Electrode placement procedure"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "Results"
          "secciones" => array:6 [
            0 => array:3 [
              "identificador" => "sec0025"
              "titulo" => "Analysis of the pros and cons of the different types of electrodes"
              "secciones" => array:1 [
                0 => array:2 [
                  "identificador" => "sec0030"
                  "titulo" => "Ambu&#174; Neuroline Subdermal Needle"
                ]
              ]
            ]
            1 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Pediatric Silver Cup Electrodes&#44; Natus&#174; Neurology"
            ]
            2 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Self-adhesive pre-gelled solid Hydrogel electrodes &#40;Neonatal Hydrogel Sensors&#44; Natus&#174; Neurology and Ambu&#174; Neuroline 700&#41;"
            ]
            3 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Self-adhesive pre-gelled wet gel electrodes with pre-attached lead wire &#40;Ambu&#174; Neuroline 720&#41; and without pre-attached wire &#40;Ambu&#174; BlueSensor N used with Natus&#174; Neurology reusable snap leads&#41;"
            ]
            4 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Selection of the optimal electrode"
            ]
            5 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Applicability to clinical practice"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Conclusion"
        ]
        9 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:2 [
          "identificador" => "xack575294"
          "titulo" => "Acknowledgments"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-07-27"
    "fechaAceptado" => "2020-09-10"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1454859"
          "palabras" => array:6 [
            0 => "Electroencephalography"
            1 => "Electrodes"
            2 => "Electrical impedance"
            3 => "Extreme premature"
            4 => "Neonate"
            5 => "Intensive Care Units&#44; Neonatal"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1454860"
          "palabras" => array:6 [
            0 => "Electroencefalograf&#237;a"
            1 => "Electrodos"
            2 => "Impedancia el&#233;ctrica"
            3 => "Prematuro extremo"
            4 => "Neonato"
            5 => "Unidades de Cuidados Intensivos&#44; Neonatal"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Monitoring of brain function using continuous electroencephalography &#40;aEEG&#47;cEEG&#41; is an essential tool in the standard care of the term infant&#44; and its use is growing in the premature infant as a biomarker of lesion and brain maturity&#46; However&#44; the placing of the electrodes is a great challenge&#44; particularly in the extremely premature infant&#44; which often discourages neuromonitoring&#46; The aim of this study is to assess the different electrodes available&#44; to select the one that best suits the peculiarities of the extremely premature infant&#44; and evaluate its applicability in clinical practice&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Population and methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">With the aim of designing a neuromonitoring study protocol using aEEG&#47;cEEG in &#60;28 weeks premature infants&#44; an analysis was made of our experience with the type of electrodes available&#46; The electrode that was considered most suitable for this population was chosen by assessing&#58; the need of preparing the scalp&#44; speed in positioning the electrodes&#44; if the application was invasive or not&#44; the possibility of repositioning&#44; risk of skin injuries&#44; sterility of the technique&#44; and durability&#46; The electrode chosen was used for continuous electroencephalographic monitoring started in the first 24&#8239;h of life&#44; and maintained until at least 72&#8239;h of life&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The electrodes evaluated were&#58; subdermal needles&#44; silver cups&#44; and 2 types of self-adhesive electrodes &#40;solid hydrogel and wet gel&#41;&#46; The wet gel electrodes were chosen&#46; They were used on 41 neonates with a mean gestational age of 25&#46;8&#8239;&#177;&#8239;1&#46;1 weeks&#46; Good stable impedance was rapidly obtained&#44; without the need of excessive manipulations&#44; and no skin injuries were observed&#46; The satisfaction of the staff involved in positioning them was very high&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The self-adhesive disposable electrodes with wet gel and integrated cable enabled the electrodes to be positioned rapidly and provided continuous non-invasive and good quality aEEG&#47;cEEG monitoring in the extremely premature infant&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Population and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusion"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La neuromonitorizaci&#243;n de la funci&#243;n cerebral mediante electroencefalograf&#237;a continua &#40;aEEG&#47;cEEG&#41; es una herramienta esencial en el cuidado est&#225;ndar del ni&#241;o a t&#233;rmino&#44; y de utilidad creciente en el ni&#241;o prematuro como biomarcador de lesi&#243;n y maduraci&#243;n cerebral&#46; Sin embargo&#44; la colocaci&#243;n de los electrodos supone un gran reto&#44; especialmente en el ni&#241;o prematuro extremo&#44; desalentando frecuentemente su neuromonitorizaci&#243;n&#46; El objetivo de este estudio es analizar los diferentes electrodos disponibles&#44; seleccionar el que mejor se adapta a las peculiaridades del ni&#241;o prematuro extremo y evaluar su aplicabilidad en la pr&#225;ctica cl&#237;nica&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Poblaci&#243;n y m&#233;todos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Con motivo del dise&#241;o de un protocolo de estudio de neuromonitorizaci&#243;n mediante aEEG&#47;cEEG en ni&#241;os prematuros &#60;28 semanas&#44; analizamos nuestra experiencia con los tipos de electrodos disponibles y seleccionamos el que consideramos m&#225;s adecuado para esta poblaci&#243;n mediante la valoraci&#243;n de&#58; necesidad de preparaci&#243;n del cuero cabelludo&#44; rapidez de colocaci&#243;n&#44; si se trataba de una aplicaci&#243;n invasiva&#44; posibilidad de reposicionamiento&#44; riesgo de lesiones cut&#225;neas&#44; esterilidad de la t&#233;cnica y durabilidad&#46; El electrodo elegido se utiliz&#243; para la monitorizaci&#243;n continua electroencefalogr&#225;fica iniciada en las primeras 24&#8239;h de vida y mantenida al menos hasta las 72&#8239;h&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Los electrodos evaluados fueron&#58; agujas subd&#233;rmicas&#44; cucharillas de plata y 2 tipos de electrodos autoadhesivos &#40;de hidrogel s&#243;lido y de gel conductor l&#237;quido&#41;&#46; Los electrodos de gel conductor l&#237;quido fueron los elegidos&#46; Se utilizaron en 41 neonatos con una edad gestacional media de 25&#44;8&#8239;&#177;&#8239;1&#44;1 semanas&#46; Se obtuvo una buena impedancia duradera de forma r&#225;pida y sin necesidad de manipulaciones excesivas y no observamos lesiones cut&#225;neas&#46; La satisfacci&#243;n del personal involucrado en su colocaci&#243;n fue muy elevada&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Los electrodos autoadhesivos desechables con gel conductor l&#237;quido y cable integrado permiten una colocaci&#243;n r&#225;pida y no invasiva para una monitorizaci&#243;n aEEG&#47;cEEG prolongada y de buena calidad en el ni&#241;o prematuro extremo&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Poblaci&#243;n y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Cordeiro M&#44; Peinado H&#44; Montes MT&#44; Valverde E&#46; Evaluaci&#243;n de la idoneidad y aplicabilidad cl&#237;nica de diferentes electrodos para la monitorizaci&#243;n aEEG&#47;cEEG en el ni&#241;o prematuro extremo&#46; An Pediatr &#40;Barc&#41;&#46; 2021&#59;95&#58;423&#8211;430&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1012
            "Ancho" => 1738
            "Tamanyo" => 169991
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Preparation and placement of electrodes&#58; &#40;A&#41; Label both ends of each electrode with the corresponding anatomical site&#59; &#40;B&#41; group all the cables in a tubular stockinette bandage&#59; &#40;C&#41; apply a small amount of adhesive conductive gel to the sponge in the electrode&#59; &#40;D&#41; apply all the electrodes for one side of the head&#44; then all the electrodes for the other side&#59; &#40;E&#41; Slip the tubular bandage over the head to serve as a holding cap&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 404
            "Ancho" => 1500
            "Tamanyo" => 47900
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Self-adhesive wet gel electrodes with and without pre-attached lead wires&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2300
            "Ancho" => 3167
            "Tamanyo" => 537234
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Evaluation of the different types of electrodes used in our neonatal unit&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:33 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Brain monitoring in neonates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;C&#46; Toet"
                            1 => "P&#46;M&#46; Lemmers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.earlhumdev.2008.11.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Early Hum Dev"
                        "fecha" => "2009"
                        "volumen" => "85"
                        "paginaInicial" => "77"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19150756"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous brain-function monitoring&#58; state of the art in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Hellstr&#246;m-Westas"
                            1 => "I&#46; Ros&#233;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Semin Fetal Neonatal Med"
                        "fecha" => "2006"
                        "volumen" => "11"
                        "paginaInicial" => "503"
                        "paginaFinal" => "511"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amplitude-integrated electroencephalography in newborns with inborn errors of metabolism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Olischar"
                            1 => "E&#46; Shany"
                            2 => "C&#46; Ayg&#252;n"
                            3 => "D&#46; Azzopardi"
                            4 => "R&#46;W&#46; Hunt"
                            5 => "M&#46;C&#46; Toet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000339567"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neonatology"
                        "fecha" => "2012"
                        "volumen" => "102"
                        "paginaInicial" => "203"
                        "paginaFinal" => "211"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22797054"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amplitude integrated electroencephalogram as a prognostic tool in neonates with hypoxic-ischemic encephalopathy&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46; Del R&#237;o"
                            1 => "C&#46; Ochoa"
                            2 => "A&#46; Alarcon"
                            3 => "J&#46; Arn&#225;ez"
                            4 => "D&#46; Blanco"
                            5 => "A&#46; Garc&#237;a-Alix"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0166947"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28002457"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amplitude-integrated electroencephalography for seizure detection in newborn infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Hellstr&#246;m-Westas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Semin Fetal Neonatal Med"
                        "fecha" => "2018"
                        "volumen" => "23"
                        "paginaInicial" => "175"
                        "paginaFinal" => "182"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebral function monitoring during the first week of life in extremely small low birthweight &#40;ESLBW&#41; infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Hellstr&#246;m-Westas"
                            1 => "I&#46; Ros&#233;n"
                            2 => "N&#46;W&#46; Svenningsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-2008-1071411"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuropediatrics"
                        "fecha" => "1991"
                        "volumen" => "22"
                        "paginaInicial" => "27"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2038424"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early prediction of outcome with aEEG in preterm infants with large intraventricular hemorrhages"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Hellstr&#246;m-Westas"
                            1 => "H&#46; Klette"
                            2 => "K&#46; Thorngren-Jerneck"
                            3 => "I&#46; Ros&#233;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-2001-20408"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuropediatrics"
                        "fecha" => "2001"
                        "volumen" => "32"
                        "paginaInicial" => "319"
                        "paginaFinal" => "324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11870588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebral function monitoring&#58; a new scoring system for the evaluation on brain maturation in neonates"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;F&#46; Burdjalov"
                            1 => "S&#46; Baumgart"
                            2 => "A&#46;R&#46; Spitzer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.112.4.855"
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2003"
                        "volumen" => "112"
                        "paginaInicial" => "855"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14523177"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reference values for amplitude-integrated electroencephalographic activity in preterm infants younger than 30 weeks&#8217; gestational age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Olischar"
                            1 => "K&#46; Klebermass"
                            2 => "S&#46; Kuhle"
                            3 => "M&#46; Hulek"
                            4 => "C&#46; Kohlhauser"
                            5 => "E&#46; R&#252;cklinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.113.1.e61"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2004"
                        "volumen" => "113"
                        "paginaInicial" => "e61"
                        "paginaFinal" => "e66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14702497"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Background patterns and sleep-wake cycles on amplitude-integrated electroencephalography in preterms younger than 30 weeks gestational age with peri-&#47;intraventricular haemorrhage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Olischar"
                            1 => "K&#46; Klebermass"
                            2 => "T&#46; Waldhoer"
                            3 => "A&#46; Pollak"
                            4 => "M&#46; Weninger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1651-2227.2007.00462.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2007"
                        "volumen" => "96"
                        "paginaInicial" => "1743"
                        "paginaFinal" => "1750"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17971193"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Decreased aEEG continuity and baseline variability in the first 48 hours of life associated with poor short-term outcome in neonates born before 29 weeks gestation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;R&#46; Bowen"
                            1 => "M&#46; Paradisis"
                            2 => "D&#46; Shah"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1203/PDR.0b013e3181d4ecda"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2010"
                        "volumen" => "67"
                        "paginaInicial" => "538"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20098343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low-voltage aEEG as predictor of intracranial hemorrhage in preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;F&#46; Chalak"
                            1 => "N&#46;C&#46; Sikes"
                            2 => "M&#46;J&#46; Mason"
                            3 => "J&#46;R&#46; Kaiser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.pediatrneurol.2010.11.018"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Neurol"
                        "fecha" => "2011"
                        "volumen" => "44"
                        "paginaInicial" => "364"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21481745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amplitude-integrated electroencephalography in preterm infants with cystic periventricular leukomalacia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Kato"
                            1 => "A&#46; Okumura"
                            2 => "F&#46; Hayakawa"
                            3 => "T&#46; Tsuji"
                            4 => "J&#46; Natsume"
                            5 => "M&#46; Hayakawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.earlhumdev.2010.12.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Early Hum Dev"
                        "fecha" => "2011"
                        "volumen" => "87"
                        "paginaInicial" => "217"
                        "paginaFinal" => "221"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21237587"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amplitude-integrated EEG pattern predicts further outcome in preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; Klebermass"
                            1 => "M&#46; Olischar"
                            2 => "T&#46; Waldhoer"
                            3 => "R&#46; Fuiko"
                            4 => "A&#46; Pollak"
                            5 => "M&#46; Weninger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1203/PDR.0b013e31821ba200"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2011"
                        "volumen" => "70"
                        "paginaInicial" => "102"
                        "paginaFinal" => "108"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21436758"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Absent cyclicity on aEEG within the first 24 h is associated with brain damage in preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Kidokoro"
                            1 => "T&#46; Kubota"
                            2 => "N&#46; Hayashi"
                            3 => "M&#46; Hayakawa"
                            4 => "K&#46; Takemoto"
                            5 => "Y&#46; Kato"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0030-1270479"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuropediatrics"
                        "fecha" => "2010"
                        "volumen" => "41"
                        "paginaInicial" => "241"
                        "paginaFinal" => "245"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21445813"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early abnormal amplitude-integrated electroencephalography &#40;aEEG&#41; is associated with adverse short-term outcome in premature infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Soubasi"
                            1 => "K&#46; Mitsakis"
                            2 => "K&#46; Sarafidis"
                            3 => "M&#46; Griva"
                            4 => "C&#46;T&#46; Nakas"
                            5 => "V&#46; Drossou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejpn.2012.02.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Paediatr Neurol"
                        "fecha" => "2012"
                        "volumen" => "16"
                        "paginaInicial" => "625"
                        "paginaFinal" => "630"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22425390"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early single-channel aEEG&#47;EEG predicts outcome in very preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Wikstr&#246;m"
                            1 => "I&#46;H&#46; Pupp"
                            2 => "I&#46; Ros&#233;n"
                            3 => "E&#46; Norman"
                            4 => "V&#46; Fellman"
                            5 => "D&#46; Ley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1651-2227.2012.02677.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2012"
                        "volumen" => "101"
                        "paginaInicial" => "719"
                        "paginaFinal" => "726"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22530996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low-voltage pattern and absence of sleep-wake cycles are associated with severe hemorrhage and death in very preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Benavente-Fern&#225;ndez"
                            1 => "S&#46;P&#46; Lubi&#225;n-L&#243;pez"
                            2 => "G&#46; Jim&#233;nez-G&#243;mez"
                            3 => "A&#46;M&#46; Lechuga-Sancho"
                            4 => "M&#46; Garcia-Alloza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00431-014-2360-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Pediatr"
                        "fecha" => "2015"
                        "volumen" => "174"
                        "paginaInicial" => "85"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24997846"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early amplitude-integrated electroencephalography predicts brain injury and neurological outcome in very preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Song"
                            1 => "F&#46; Xu"
                            2 => "L&#46; Wang"
                            3 => "L&#46; Gao"
                            4 => "J&#46; Guo"
                            5 => "L&#46; Xia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-018-32192-w"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep"
                        "fecha" => "2015"
                        "volumen" => "8"
                        "paginaInicial" => "13810"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30217996"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The predictive value of amplitude-integrated electroencephalography in preterm infants for IQ and other neuropsychological outcomes at early school age"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46;G&#46; Middel"
                            1 => "N&#46; Brandenbarg"
                            2 => "K&#46;N&#46;J&#46;A&#46; Van Braeckel"
                            3 => "A&#46;F&#46; Bos"
                            4 => "H&#46;J&#46; Ter Horst"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000486704"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neonatology"
                        "fecha" => "2018"
                        "volumen" => "113"
                        "paginaInicial" => "287"
                        "paginaFinal" => "295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29439269"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Amplitude-integrated electroencephalography in the NICU&#58; frequent artifacts in premature infants may limit its utility as a monitoring device"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Suk"
                            1 => "A&#46;N&#46; Krauss"
                            2 => "M&#46; Engel"
                            3 => "J&#46;M&#46; Perlman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2009"
                        "volumen" => "123"
                        "paginaInicial" => "e328"
                        "paginaFinal" => "32"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Need for quality control for aEEG monitoring of the preterm infant&#58; a 2-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Griesmaier"
                            1 => "V&#46; Neubauer"
                            2 => "E&#46; Ralser"
                            3 => "R&#46; Traw&#246;ger"
                            4 => "U&#46; Kiechl-Kohlendorfer"
                            5 => "M&#46; Keller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1651-2227.2011.02206.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2011"
                        "volumen" => "100"
                        "paginaInicial" => "1079"
                        "paginaFinal" => "1083"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21352354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Electroencephalography &#40;EEG&#41; recording techniques and artefact detection in early premature babies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Walls-Esquivel"
                            1 => "M&#46;F&#46; Vecchierini"
                            2 => "C&#46; H&#233;berl&#233;"
                            3 => "F&#46; Wallois"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.neucli.2007.09.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurophysiol Clin"
                        "fecha" => "2007"
                        "volumen" => "37"
                        "paginaInicial" => "299"
                        "paginaFinal" => "309"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18063232"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Overcoming the practical challenges of electroencephalography for very preterm infants in the neonatal intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Lloyd"
                            1 => "R&#46; Goulding"
                            2 => "P&#46; Filan"
                            3 => "G&#46; Boylan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/apa.12869"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
                        "fecha" => "2015"
                        "volumen" => "104"
                        "paginaInicial" => "152"
                        "paginaFinal" => "157"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25495482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive continuous monitoring of the effects of head position on brain hemodynamics in ventilated infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Pellicer"
                            1 => "F&#46; Gay&#225;"
                            2 => "R&#46; Madero"
                            3 => "J&#46; Quero"
                            4 => "F&#46; Caba&#241;as"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/peds.109.3.434"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2002"
                        "volumen" => "109"
                        "paginaInicial" => "434"
                        "paginaFinal" => "440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11875138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous brain-function monitoring&#58; state of the art in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46; Hellstr&#246;m-Westas"
                            1 => "I&#46; Ros&#233;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.siny.2006.07.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Fetal Neonatal Med"
                        "fecha" => "2006"
                        "volumen" => "11"
                        "paginaInicial" => "503"
                        "paginaFinal" => "511"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17067863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "American Clinical Neurophysiology Society Guideline 5&#58; minimum technical standards for pediatric electroencephalography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Kuratani"
                            1 => "P&#46;L&#46; Pearl"
                            2 => "L&#46; Sullivan"
                            3 => "R&#46;M&#46; Riel-Romero"
                            4 => "J&#46; Cheek"
                            5 => "M&#46; Stecker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Neurophysiol"
                        "fecha" => "2016"
                        "volumen" => "33"
                        "paginaInicial" => "320"
                        "paginaFinal" => "323"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Electrode challenges in amplitude-integrated electroencephalography &#40;aEEG&#41;&#58; research application of a novel noninvasive measure of brain function in preterm infants"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;W&#46; Foreman"
                            1 => "L&#46; Thorngate"
                            2 => "R&#46;L&#46; Burr"
                            3 => "K&#46;A&#46; Thomas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Biol Res Nurs"
                        "fecha" => "2011"
                        "volumen" => "13"
                        "paginaInicial" => "251"
                        "paginaFinal" => "259"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surface electrical capacitance as a noninvasive bedside measure of epidermal barrier maturation in the newborn infant"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "F&#46;A&#46; Okah"
                            1 => "R&#46;R&#46; Wickett"
                            2 => "W&#46;L&#46; Pickens"
                            3 => "S&#46;B&#46; Hoath"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1995"
                        "volumen" => "96"
                        "paginaInicial" => "688"
                        "paginaFinal" => "692"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7567331"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Feasibility of long-term continuous EEG monitoring during the first days of life in preterm infants&#58; an automated quantification of the EEG activity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46;M&#46; Schumacher"
                            1 => "A&#46;S&#46; Westvik"
                            2 => "P&#46;G&#46; Larsson"
                            3 => "R&#46; Lindemann"
                            4 => "J&#46; Westvik"
                            5 => "T&#46;A&#46; Stiris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1203/PDR.0b013e31821267d2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Res"
                        "fecha" => "2011"
                        "volumen" => "69"
                        "paginaInicial" => "413"
                        "paginaFinal" => "417"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21283050"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scalp electrode impedance&#44; infection risk&#44; and EEG data quality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;C&#46; Ferree"
                            1 => "P&#46; Luu"
                            2 => "G&#46;S&#46; Russell"
                            3 => "D&#46;M&#46; Tucker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s1388-2457(00)00533-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Neurophysiol"
                        "fecha" => "2001"
                        "volumen" => "112"
                        "paginaInicial" => "536"
                        "paginaFinal" => "544"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11222977"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long term electroencephalography in preterm neonates&#58; safety and quality of electrode types"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;M&#46; El Ters"
                            1 => "A&#46;M&#46; Mathur"
                            2 => "S&#46; Jain"
                            3 => "Z&#46;A&#46; Vesoulis"
                            4 => "J&#46;M&#46; Zempel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clinph.2018.02.129"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Neurophysiol"
                        "fecha" => "2018"
                        "volumen" => "129"
                        "paginaInicial" => "1366"
                        "paginaFinal" => "1371"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29729590"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of dry sensors for neonatal EEG recordings"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Fridman"
                            1 => "M&#46; Cordeiro"
                            2 => "K&#46; Rais-Bahrami"
                            3 => "N&#46;J&#46; McDonald"
                            4 => "J&#46;J&#46; Reese Jr"
                            5 => "A&#46;N&#46; Massaro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/WNP.0000000000000237"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Neurophysiol"
                        "fecha" => "2016"
                        "volumen" => "33"
                        "paginaInicial" => "149"
                        "paginaFinal" => "155"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26562208"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack575294"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0155" class="elsevierStylePara elsevierViewall">We thank all nurses and nursing assistants in the neonatal unit for their collaboration and substantial contribution to this study&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000009500000006/v2_202112161235/S2341287921001587/v2_202112161235/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "26005"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009500000006/v2_202112161235/S2341287921001587/v2_202112161235/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287921001587?idApp=UINPBA00005H"
]