Influence of Respiratory Acidosis and Blood Glucose on Cerebral Activity of Premature Infants

Granot, Shiri; Meledin, Irina; Richardson, Justin; Friger, Michael; Shany, Eilon

doi:10.1016/j.pediatrneurol.2012.03.018

Cited by 14 publications

(10 citation statements)

References 22 publications

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“…Additionally, there was a tendency of higher glucose levels in infants with developmental indices <85. This result was in accordance with the studies by Wikström et al [19] and Granot et al [20]. …”

Section: Discussionsupporting

confidence: 94%

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Automated Spectral EEG Analyses of Premature Infants during the First Three Days of Life Correlated with Developmental Outcomes at 24 Months

et al. 2013

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Background: Spectral EEG analysis using automated quantification of total absolute band power (tABP) for long-term brain monitoring is reliable. We hypothesised that tABP during the first critical days of life could be a useful tool for predicting later developmental outcomes. Objective: To determine whether measuring EEG background activity in premature infants with automated tABP quantification during the first 3 days of life correlated with their developmental outcomes at 24 months. Methods: Preterm infants (group 1, gestational age, GA 24–28 weeks and group 2, GA 28–31 weeks) were continuously monitored by EEG for 3 days after birth. Their developmental outcomes were assessed using the Bayley-II and Peabody-2 developmental tests at 24 months. Their respective indices were calculated. Normal (index ≥85) and abnormal (index <85) outcomes were correlated with the tABP. Results: In group 1, the tABP was significantly lower in the abnormal infants than in the normal infants. The specificity and negative predictive value were also high for all of the tests that were applied in this group. In group 2, there was no correlation between the tABP and developmental outcome. Conclusion: This study found that extremely premature infants with poor developmental outcomes had significantly lower tABP values in their first days of life compared to infants from the same group with normal outcomes. This method may be useful in predicting later outcomes in extremely premature infants and has the advantage of being automated.

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Section: Discussionsupporting

confidence: 94%

“…Recent studies have demonstrated that blood glucose, CO 2 as well as pH affect EEG background activity in preterm infants [19,20]. The effect of this on long-term outcome is not known.…”

Section: Discussionmentioning

confidence: 99%

Automated Spectral EEG Analyses of Premature Infants during the First Three Days of Life Correlated with Developmental Outcomes at 24 Months

et al. 2013

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“…Victor et al (9) showed that lower levels of PcO 2 were associated with increased cerebral fractional oxygen extraction and slowing of EEG, while higher levels of PcO 2 were associated with suppression of EEG during the first 48 h of age. Granot et al (13) using amplitude integrated EEG on 65 preterm babies born before 28 wk gestational age showed that respiratory acidosis and hyperglycemia during the first 72 h after birth was associated with suppressed electrical activity. Wikström et al (14) using one-channel EEG reported that in a cohort of 32 babies born before 28 wk gestation higher levels of PcO 2 were associated with suppressed cerebral electrical activity.…”

Section: Permissive Hypercapnia and Eegmentioning

confidence: 99%

Effect of permissive hypercapnia on background cerebral electrical activity in premature babies

et al. 2014

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ArticlesClinical Investigation nature publishing group background: Permissive hypercapnia is routinely practiced in neonatal intensive care units. The effect of permissive hypercapnia on the preterm brain and brain electrical activity is unknown. In this study, we aimed to determine the effect of chronic changes in partial pressure of blood carbon dioxide (PcO 2 ) on brain electrical activity in preterm newborn babies born at or before 32 wk gestation. Methods: Eighty-three 1-h long digital electroencephalography (EEG) recordings were performed once a week for 4 wk on 25 babies with median gestational age of 29 wk (range: 23-32) after 48 h of age. Capillary blood gas measurements were performed midway through EEG recordings. results: There are associations between EEG parameters and blood pH, PcO 2 , and blood glucose concentration. However, there are also strong and complex associations with gestational age and substantial individual patient effects that make it difficult to demonstrate predictive associations. PcO 2 and bicarbonate are significantly correlated with relative power of θ EEG band and Δ EEG band respectively after adjustment for age and intrababy correlations, but after allowing for multiple testing these relationships are of borderline statistical significance. conclusion: Compensated respiratory acidosis may affect EEG by increased delta wave activity in preterm babies born before 32 wk gestation.

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“…Recently, it has been demonstrated that pH, pCO 2 and blood glucose may influence brain activity [8,9]. Glucose levels affect the burst and interburst interval (IBI) with decreasing burst activity and increased IBI during both hypoglycemia and hyperglycemia [8].…”

Section: Introductionmentioning

confidence: 99%

“…Glucose levels affect the burst and interburst interval (IBI) with decreasing burst activity and increased IBI during both hypoglycemia and hyperglycemia [8]. A decrease in pH as well as an increase in pCO 2 reduces background brain activity assessed by amplitude-integrated EEG [9]. We therefore hypothesized that there was a relationship between pCO 2 , blood glucose and tABP in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Blood Glucose and pCO<sub>2</sub> on Spectral EEG of Premature Infants during the First Three Days of Life

Schumacher

Larsson²,

Pripp³

et al. 2014

Neonatology

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Background: Spectral EEG analysis using automated quantification of total absolute band power (tABP) expresses brain function. We hypothesized that pCO₂ or blood glucose affects tABP during the critical first days of life in premature infants. Objective: To use automated tABP quantification to determine whether EEG background activity in premature infants during the first 3 days of life is influenced by pCO₂ or blood glucose levels. Methods: Preterm infants, group 1 [gestational age (GA) = 24-27 weeks] and group 2 (GA = 28-30 weeks), underwent continuous EEG monitoring for 3 days after birth. Biochemical data were extracted from the observational datasheet used during monitoring. Blood samples were taken at the request of the attending physician. Statistical analyses were performed as repeated measurements using linear mixed models with a random intercept. The effect of time was treated as a fixed covariate and the GA groups as a fixed factor in all models. Continuous data were described using the mean ± SD or median and range, and categorical data were described using the number of patients and percentages unless otherwise indicated. Results: There was an association between increased pCO₂ and tABP and between increased blood glucose and tABP. Further, there were no differences in the responses between groups 1 and 2. Conclusion: Both hyperglycemia and hypercapnia showed a negative effect on brain activity decreasing tABP during the first 3 days of life in premature infants.

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Influence of Respiratory Acidosis and Blood Glucose on Cerebral Activity of Premature Infants

Cited by 14 publications

References 22 publications

Automated Spectral EEG Analyses of Premature Infants during the First Three Days of Life Correlated with Developmental Outcomes at 24 Months

Automated Spectral EEG Analyses of Premature Infants during the First Three Days of Life Correlated with Developmental Outcomes at 24 Months

Effect of permissive hypercapnia on background cerebral electrical activity in premature babies

The Effect of Blood Glucose and pCO<sub>2</sub> on Spectral EEG of Premature Infants during the First Three Days of Life

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