Original ArticlesAmplitude-Integrated Electroencephalography Improves the Identification of Infants with Encephalopathy for Therapeutic Hypothermia and Predicts Neurodevelopmental Outcomes at 2 Years of Age
Section snippets
Methods
Full-term newborn infants with perinatal asphyxia treated with therapeutic hypothermia were enrolled prospectively from a single center (Ullevål Neonatal Intensive Care Unit, Oslo University Hospital, Oslo, Norway) from January 1, 2010 to December 31, 2011. Fifty-three neonates were treated with whole body cooling for 3 days as standard of care under the Norwegian National Guidelines for therapeutic hypothermia.11 In 3 infants, consent to partake in the study was not obtained, and 3 others were
Results
Table I shows the demographic, baseline, clinical, and outcome variables for the 47 included infants, divided into 3 severity groups based on their initial aEEG pattern. Fifteen infants had CNV (normal), 18 had DNV (moderately abnormal), and 14 had SEVP (severely abnormal) aEEG patterns.17, 18 The median start time of aEEG monitoring for the whole cohort was 6 hours. The aEEG was applied earlier in the CNV (median 4 hours) than the DNV (7 hours) and SEVP (6 hours) groups, because more CNV were
Discussion
The first 3 large, randomized, controlled trials of therapeutic hypothermia5, 8, 10 included infants with moderate or severe, but not mild, encephalopathy. These trials used similar entry criteria except that the presence of a depressed aEEG as a marker of encephalopathy was not used in the National Institute of Child Health and Development trial as an entry criterion. Presently, centers outside the United States, particularly those who initiate therapeutic hypothermia without recording an
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2024, Anales de PediatriaNewborns at high risk for brain injury: the role of the amplitude-integrated electroencephalography
2022, Jornal de PediatriaMRI combined with early clinical variables are excellent outcome predictors for newborn infants undergoing therapeutic hypothermia after perinatal asphyxia
2021, EClinicalMedicineCitation Excerpt :These are the severity pattern of aEEG, [21,24] the peak LDH (LDHpeak), LDH value at 72h (LDH72h), [25,26] time for plasma lactate to fall below 5 mmol (lactatehrs<5mmol) [21] and the number of inotropic and anticonvulsant drugs used during TH [27] as proxy-markers for hypotension and seizure burden respectively. We confirm in this paper the usefulness of these measures previously proposed for outcome prediction [21,24,26,27]. In this population-based cohort study with a wide range of infants, with HIE including those with comorbidities or additional diagnoses more representative of current cooling practices we aim to test:
J.S. has a PhD fellowship from the Faculty of Medicine, University of Oslo. M.T. is funded by the University of Oslo, The Norwegian Research Council and SPARKS (UK) Charitable foundation. The authors declare no conflicts of interest.