Accuracy of amplitude‐integrated electroencephalography in the prediction of neurodevelopmental outcome in asphyxiated infants receiving hypothermia treatment

Csekő, AJ; Bangó, Márta; Lakatos, László; Kárdási, J; Pusztai, Lajos; Szabó, Miklós

doi:10.1111/apa.12226

Cited by 62 publications

(46 citation statements)

References 20 publications

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“…5). 24,25 In the TOBY randomized trial of cooling, the predictive value of aEEG within 6 hours of birth was lower in the cooled group than in the non-cooled group, but the PPV was lower in both groups than previously reported (PPV of 55% in the cooled group, compared with 63% in the non-cooled group). The best PPV was obtained when the low-voltage and flat trace patterns were combined to define the most severely abnormal patterns (PPV of 59% vs 71% for the cooled and non-cooled groups, respectively).…”

Section: Amplitude-integrated Eegmentioning

confidence: 71%

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Merchant

Azzopardi

2015

Develop Med Child Neuro

100

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Hypoxic–ischaemic encephalopathy (HIE) is a leading cause of acquired neonatal brain injury. Assessment of the severity of cerebral injury and likely neurological outcome in infants with HIE is important for determining management and prognosis, for counselling parents, and for selection for neuroprotective trials. The condition of the infant at birth, the severity of HIE, neurophysiological tests, including amplitude‐integrated electroencephalography (aEEG), biochemical markers, and neuroimaging have been used to assess prognosis and predict long‐term outcome. The predictive accuracy of these indicators in the early postnatal period is modest. Neurophysiological assessment seems to be most helpful during the first 24 to 48 hours after birth whilst magnetic resonance imaging (MRI) seems most informative later. Several biochemical markers, including serum S100β and neuron‐specific enolase (NSE), are also associated with HIE but their levels depend on the timing of sampling and their prognostic value is uncertain. Comprehensive neurophysiological assessment and neuroimaging may be limited to specialist centres. Therapeutic hypothermia is now standard care in infants with moderate to severe HIE so it is important to examine the influence of hypothermia on the assessment of prognosis in these infants.

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Section: Amplitude-integrated Eegmentioning

confidence: 71%

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Merchant

Azzopardi

2015

Develop Med Child Neuro

100

View full text Add to dashboard Cite

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“…The cooling method used and the population studied may limit the applicability of the results in other populations, and further research is needed in these settings. The morphine and anticonvulsants may have influenced the clinical findings and the aEEG background, but the aEEG background improved more frequently in those infants who received morphine, and several studies have shown that the doses we used are unlikely to have significantly influenced the aEEG background . The lack of long‐term follow‐up is a further limitation that is difficult to address as a result of the transient interprovincial migration of many mothers .…”

Section: Discussionmentioning

confidence: 99%

Early clinical predictors of a severely abnormal amplitude‐integrated electroencephalogram at 48 hours in cooled neonates

et al. 2013

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“…Researchers have attempted to use amplitude-integrated EEG (aEEG) to predict outcome in neonates with neuronal injury, but the results are conflicting 36,37 and falsely abnormal aEEGs have been reported with shivering in the hypothermic neonate. 29,35 Reliable prediction of outcome (PPV = 0.92) by abnormal aEEG background was demonstrated only at 60 hours after HIE, but not at earlier stages.…”

Section: Discussionmentioning

confidence: 99%

Can We Predict Functional Outcome in Neonates with Hypoxic Ischemic Encephalopathy by the Combination of Neuroimaging and Electroencephalography?

Nanavati

Seemaladinne

Regier

et al. 2015

Pediatrics & Neonatology

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Background Neonatal hypoxic ischemic encephalopathy (HIE) is a major cause of mortality, morbidity, and long-term neurological deficits. Despite the availability of neuroimaging and neurophysiological testing, tools for accurate early diagnosis and prediction of developmental outcome are still lacking. The goal of this study was to determine if combined use of magnetic resonance imaging (MRI) and electroencephalography (EEG) findings could support outcome prediction. Methods We retrospectively reviewed records of 17 HIE neonates, classified brain MRI and EEG findings based on severity, and assessed clinical outcome up to 48 months. We determined the relation between MRI/EEG findings and clinical outcome. Results We demonstrated a significant relationship between MRI findings and clinical outcome (Fisher’s exact test, p = 0.017). EEG provided no additional information about the outcome beyond that contained in the MRI score. The statistical model for outcome prediction based on random forests suggested that EEG readings at 24 hours and 72 hours could be important variables for outcome prediction, but this needs to be investigated further. Conclusion Caution should be used when discussing prognosis for neonates with mild-to-moderate HIE based on early MR imaging and EEG findings. A robust, quantitative marker of HIE severity that allows for accurate prediction of long-term outcome, particularly for mild-to-moderate cases, is still needed.

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Accuracy of amplitude‐integrated electroencephalography in the prediction of neurodevelopmental outcome in asphyxiated infants receiving hypothermia treatment

Abstract: Amplitude-integrated electroencephalography provides reliable prediction of outcome from the 48th hour during hypothermia in HIE infants. Commonly used CNS drugs in HIE infants do not significantly delay aEEG recovery.

Cited by 62 publications

References 20 publications

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Early clinical predictors of a severely abnormal amplitude‐integrated electroencephalogram at 48 hours in cooled neonates

Can We Predict Functional Outcome in Neonates with Hypoxic Ischemic Encephalopathy by the Combination of Neuroimaging and Electroencephalography?

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