Influence of hypothermia on the prognostic value of early EEG in full-term neonates with hypoxic ischemic encephalopathy

Hamelin, Sophie; Delnard, N.; Cneude, F.; Debillon, Thierry; Vercueil, Laurent

doi:10.1016/j.neucli.2010.11.002

Cited by 44 publications

(39 citation statements)

References 31 publications

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“…EEG appears not to be significantly affected by HT [113,114] and so it is reasonable to include studies with babies treated with HT as we have done for [47,[51][52][53][54][55].…”

Section: Validity Of Results In Newborns Treated With Hypothermiamentioning

confidence: 99%

“…The benefits of EEG are that it can easily be implemented at the cotside soon after birth and it provides a realtime measure of cerebral function [12]. Detecting seizures [29,45,46] and assessing response to anticonvulsants [47] …”

Section: Thesis Organisationmentioning

confidence: 99%

“…Studies used structured examinations [96][97][98][99][100][101] and/or general neurological examinations [102][103][104][105][106] to define 'normal' or 'abnormal' neurodevelopmental outcome as shown in Table 2.2. A few studies used their own follow up index to define 'normal' or 'abnormal' outcome [47,69,71]. Some studies sub-classified outcome as normal, minor or mildly abnormal, moderate and severely abnormal or death.…”

Section: Assessment Of Neurodevelopmental Outcomementioning

confidence: 99%

“…setting [47], and is particularly useful because many seizures in the newborn have no detectable clinical manifestations.…”

Section: What Is the Contribution Of This Study?mentioning

confidence: 99%

“…To overcome these limitations, an automated detection and classification approach would provide a decision support to the clinical staff. The system needs to monitor and assess recovery of background EEG activity, as a normal EEG is highly predictive of a normal outcome, whereas various abnormal EEG features have been consistently associated with neurological abnormalities or death [47].…”

Section: Visual Inspection Of the Eeg Signal Is Routine But Visual Inmentioning

confidence: 99%

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Design and optimisation of time-frequency analysis for multichannel neonatal EEG background features in term neonates with hypoxic ischaemic encephalopathy: characterisation, classification and neurodevelopmental outcome prediction

Awal¹

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Neonatal Hypoxic Ischaemic Encephalopathy (HIE) is a major cause of morbidity and mortality in newborns throughout the world with an incidence of 1-8/1000 newborns in developed countries and up to 26/1000 newborns in developing countries. It causes one million neonatal deaths globally per year. Electroencephalography (EEG) is a useful method for assessment of brain activity in newborns with HIE. EEG performs well in the early diagnosis and classification of HIE severity and in predicting neurodevelopmental outcome. A normal EEG is highly predictive of a normal outcome and various abnormal EEG features are associated with neurological abnormalities or death.A systematic review and meta-analysis of the literature was undertaken to determine which specific background features of the EEG best predict outcome (Aim 1). Automatic detection and classification

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“…EEG appears not to be significantly affected by HT [113,114] and so it is reasonable to include studies with babies treated with HT as we have done for [47,[51][52][53][54][55].…”

Section: Validity Of Results In Newborns Treated With Hypothermiamentioning

confidence: 99%

Section: Thesis Organisationmentioning

confidence: 99%

Section: Assessment Of Neurodevelopmental Outcomementioning

confidence: 99%

“…setting [47], and is particularly useful because many seizures in the newborn have no detectable clinical manifestations.…”

Section: What Is the Contribution Of This Study?mentioning

confidence: 99%

Section: Visual Inspection Of the Eeg Signal Is Routine But Visual Inmentioning

confidence: 99%

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Design and optimisation of time-frequency analysis for multichannel neonatal EEG background features in term neonates with hypoxic ischaemic encephalopathy: characterisation, classification and neurodevelopmental outcome prediction

Awal¹

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Predictors of Death or Severe Impairment in Neonates With Hypoxic-Ischemic Encephalopathy

Glass,

Wood,

Comstock

et al. 2024

JAMA Netw Open

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ImportanceOutcomes after hypoxic-ischemic encephalopathy (HIE) are variable. Predicting death or severe neurodevelopmental impairment (NDI) in affected neonates is crucial for guiding management and parent communication.ObjectiveTo predict death or severe NDI in neonates who receive hypothermia for HIE.Design, Setting, and ParticipantsThis prognostic study included participants enrolled in a large US clinical trial conducted in US neonatal intensive care units who were born between January 2017 and October 2019 and followed up to age 2 years. Eligible participants were neonates with moderate-severe HIE born at 36 weeks or more gestation and with 2-year outcome data. Data were analyzed June 2023. External validation was performed with a UK cohort.ExposureClinical, electroencephalography (EEG), and magnetic resonance imaging (MRI) variables were curated and examined at 24 hours and following cooling.Main Outcome and MeasuresDeath or severe NDI at age 2 years. Severe NDI was defined as Bayley Scales of Infant Toddler Development cognitive score below 70, Gross Motor Function Classification System score of 3 or higher, or quadriparesis. Model performance metrics were derived from training, internal, and external validation datasets.ResultsAmong 424 neonates (mean [SD] gestational age, 39.1 [1.4] weeks; 192 female [45.3%]; 28 Asian [6.6%], 50 Black [11.8%], 311 White [73.3%]), 105 (24.7%) had severe encephalopathy at enrollment. Overall, 59 (13.9%) died and 46 (10.8%) had severe NDI. In the 24-hour model, the combined presence of 3 clinical characteristics—(1) severely abnormal EEG, (2) pH level of 7.11 or below, and (3) 5-minute Apgar score of 0—had a specificity of 99.6% (95% CI, 97.5%-100%) and a positive predictive value (PPV) of 95.2% (95% CI, 73.2%-99.3%). Validation model metrics were 97.9% (95% CI, 92.7%-99.8%) for internal specificity, with a PPV of 77.8% (95% CI, 43.4%-94.1%), and 97.6% (95% CI, 95.1%-99.0%) for external specificity, with a PPV of 46.2% (95% CI, 23.3%-70.8%). In the postcooling model, specificity for T1, T2, or diffusion-weighted imaging (DWI) abnormality in at least 2 of 3 deep gray regions (ie, thalamus, caudate, putamen and/or globus pallidus) plus a severely abnormal EEG within the first 24 hours was 99.1% (95% CI, 96.8%-99.9%), with a PPV of 91.7% (95% CI, 72.8%-97.8%). Internal specificity in this model was 98.9% (95% CI, 94.1%-100%), with a PPV of 92.9% (95% CI, 64.2%-99.0%); external specificity was 98.6% (95% CI, 96.5%-99.6%), with a PPV of 83.3% (95% CI, 64.1%-93.4%).Conclusions and RelevanceIn this prognostic study of neonates with moderate or severe HIE who were treated with therapeutic hypothermia, simple models using readily available clinical, EEG, and MRI results during the hospital admission had high specificity and PPV for death or severe NDI at age 2 years.

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Cooling for newborns with hypoxic ischaemic encephalopathy

Jacobs

Berg

Hunt

et al. 2013

Cochrane Database of Systematic Reviews

1,280

850

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Influence of hypothermia on the prognostic value of early EEG in full-term neonates with hypoxic ischemic encephalopathy

Cited by 44 publications

References 31 publications

Design and optimisation of time-frequency analysis for multichannel neonatal EEG background features in term neonates with hypoxic ischaemic encephalopathy: characterisation, classification and neurodevelopmental outcome prediction

Design and optimisation of time-frequency analysis for multichannel neonatal EEG background features in term neonates with hypoxic ischaemic encephalopathy: characterisation, classification and neurodevelopmental outcome prediction

Predictors of Death or Severe Impairment in Neonates With Hypoxic-Ischemic Encephalopathy

Cooling for newborns with hypoxic ischaemic encephalopathy

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