EEG Suppression Associated with Apneic Episodes in a Neonate

Low, Evonne; Dempsey, Eugene M.; Ryan, C. Anthony; Rennie, Janet M.; Boylan, Geraldine B.

doi:10.1155/2012/250801

Cited by 10 publications

(25 citation statements)

References 19 publications

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“…Cerebral desaturation during apnoeic periods may be sufficiently challenging to cerebral metabolism that there is EEG suppression (Low et al . ). The preterm brain may also be exposed to spontaneous periods of desaturation (Baerts et al .…”

Section: The Global Burden Of Hypoxic–ischaemic Brain Injurymentioning

confidence: 97%

The fetus at the tipping point: modifying the outcome of fetal asphyxia

Dhillon

Lear

Galinsky

et al. 2018

The Journal of Physiology

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Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia-ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia-ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia-ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.

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Section: The Global Burden Of Hypoxic–ischaemic Brain Injurymentioning

confidence: 97%

The fetus at the tipping point: modifying the outcome of fetal asphyxia

Dhillon

Lear

Galinsky

et al. 2018

The Journal of Physiology

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“…For this purpose, techniques such as electroencephalography (EEG) can be used at the cot-side and have excellent temporal resolution, enabling the investigation of brain function before, during and after apnoeic episodes. Whilst a number of EEG studies have described seizure-related apnoeic episodes in infants, changes in the EEG related to non-seizure apnoeic episodes have not been described in detail (112)(113)(114). Low et al found that apnoeic events precipitated EEG suppression in a case report of a single infant (112).…”

Section: Understanding the Impact Of Apnoea On Brain Development In Preterm Infantsmentioning

confidence: 99%

Apnoea of Prematurity and Neurodevelopmental Outcomes: Current Understanding and Future Prospects for Research

Williamson

Poorun²,

Hartley³

2021

Front. Pediatr.

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Infants who are born prematurely are at significant risk of apnoea. In addition to the short-term consequences such as hypoxia, apnoea of prematurity has been associated with long-term morbidity, including poor neurodevelopmental outcomes. Clinical trials have illustrated the importance of methylxanthine drugs, in particular caffeine, in reducing the risk of long term adverse neurodevelopmental outcomes. However, the extent to which apnoea is causative of this secondary neurodevelopmental delay or is just associated in a background of other sequelae of prematurity remains unclear. In this review, we first discuss the pathophysiology of apnoea of prematurity, previous studies investigating the relationship between apnoea and neurodevelopmental delay, and treatment of apnoea with caffeine therapy. We propose a need for better methods of measuring apnoea, along with improved understanding of the neonatal brain's response to consequent hypoxia. Only then can we start to disentangle the effects of apnoea on neurodevelopment in preterm infants. Moreover, by better identifying those infants who are at risk of apnoea, and neurodevelopmental delay, we can work toward a risk stratification system for these infants that is clinically actionable, for example, with doses of caffeine tailored to the individual. Optimising treatment of apnoea for individual infants will improve neonatal care and long-term outcomes for this population.

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“…The EEG is exquisitely sensitive to any impairment in oxygen delivery to the brain. A reduction in oxygen leads to an immediate suppression of synaptic transmission with a reduction (often complete suppression) in EEG amplitude ( 48 , 53 ). This adaptive response, believed to be mediated by multiple inhibitory neuromodulators including adenosine, to hypoxia may be protective by decreasing energy consumed by the generation of synaptic potentials ( 54 ).…”

Section: Rationale For Proposing Eeg As a Biomarker Of Newborn Brain mentioning

confidence: 99%

Lost in Transition: A Systematic Review of Neonatal Electroencephalography in the Delivery Room—Are We Forgetting an Important Biomarker for Newborn Brain Health?

2017

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BackgroundElectroencephalography (EEG) monitoring is routine in neonatal intensive care units (NICUs) for detection of seizures, neurological monitoring of infants following perinatal asphyxia, and increasingly, following preterm delivery. EEG monitoring is not routinely commenced in the delivery room (DR).ObjectivesTo determine the feasibility of recording neonatal EEG in the DR, and to assess its usefulness as a marker of neurological well-being during immediate newborn transition.MethodsWe performed a systematic stepwise search of PubMed using the following terms: infant, newborns, neonate, DR, afterbirth, transition, and EEG. Only human studies describing EEG monitoring in the first 15 min following delivery were included. Infants of all gestational ages were included.ResultsTwo original studies were identified that described EEG monitoring of newborn infants within the DR. Both prospective observational studies used amplitude-integrated EEG (aEEG) monitoring and found it feasible in infants >34 weeks’ gestation; however, technical challenges made it difficult to obtain continuous reliable data. Different EEG patterns were identified in uncompromised newborns and those requiring resuscitation.ConclusionEEG monitoring is possible in the DR and may provide an objective baseline measure of neurological function. Further feasibility studies are required to overcome technical challenges in the DR, but these challenges are not insurmountable with modern technology.

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EEG Suppression Associated with Apneic Episodes in a Neonate

Cited by 10 publications

References 19 publications

The fetus at the tipping point: modifying the outcome of fetal asphyxia

The fetus at the tipping point: modifying the outcome of fetal asphyxia

Apnoea of Prematurity and Neurodevelopmental Outcomes: Current Understanding and Future Prospects for Research

Lost in Transition: A Systematic Review of Neonatal Electroencephalography in the Delivery Room—Are We Forgetting an Important Biomarker for Newborn Brain Health?

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