Combined vEEG and Cerebral Oximetry Results to Determine the Severity of Hypoxic–Ischemic Encephalopathy

Abstract

The objectives of the study were to evaluate the prognostic utility of bedside monitoring tools for hypoxic–ischemic encephalopathy (HIE) outcome and develop a prognostic predictive model. This retrospective study reviewed neonatal HIE treated with hypothermia between 2013 and 2016. Continuous video electroencephalography (vEEG) recordings scored for background electrocerebral activity, seizure, and sleep–wake cycles, and rSO2 data were stratified by magnetic resonance imaging (MRI) severity. The vEEG and rSO2 were combined in a predictive model. The analysis included 38 patients. The rSO2 was significantly higher in the severe group. vEEG showed early and persistent maximal suppression in the severe group. The predictive correlation of the rSO2 improves when combined with the vEEG.

Optical Monitoring in Neonatal Seizures

“…A total of 11 clinical studies were identified [ 43 , 46 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ], of which eight were case reports [ 43 , 46 , 75 , 77 , 78 , 79 , 80 , 82 ] and three were cohort studies [ 74 , 76 , 81 ]. The studies reported on NIRS parameters, HbO 2 , HHb, HbT, HbD, rSO 2 , FTOE and CCO.…”

“…Six clinical studies reported on changes in rSO 2 during neonatal seizures [ 75 , 76 , 78 , 79 , 81 , 82 ]. Between studies, there were marked similarities in rSO 2 trends.…”

“…The only substantial increase, from 63.0 to 75.6% in baseline, occurred when the inter-ictal period was 16 h. It appears as though this extended inter-ictal period acts as a recovery phase. Pacella et al [ 76 ], however, reported that during all seizures in a neonate with HIE, a statistically significant increase in rSO 2 occurred compared to inter-ictal periods.…”