Journal article
Effect of Phenobarbitone on Amplitude-Integrated Electroencephalography in Neonates with Hypoxic-Ischemic Encephalopathy during Hypothermia
Neonatology (Basel, Switzerland), Vol.117(6), pp.721-728
02/01/2021
DOI: 10.1159/000511540
PMID: 33412550
Abstract
Background: Phenobarbitone induces suppression of cerebral electrical activity on amplitude-integrated electroencephalography (aEEG) in neonates with hypoxic-ischemic encephalopathy (HIE); however, its effect during therapeutic hypothermia (TH) has not been well characterized. Objective: To evaluate the effect of phenobarbitone on aEEG in neonates with HIE undergoing TH. Methods: Thirty-five neonates born at >= 35(0) weeks gestational age (GA), who received phenobarbitone as first-line antiepileptic drug during TH for >= Sarnat stage II HIE with aEEG recordings were retrospectively studied. Background pattern, upper and lower margin voltages were characterized for a 30-min period before and 30-60 min after phenobarbitone administration. Primary outcome was presence of severely abnormal aEEG pattern after phenobarbitone administration. Results: Mean (+/- SD) GA and median birth weight were 38.2 +/- 1.9 weeks and 3.1 (2.5-3.9) kg, respectively. Phenobarbitone (10-20 mg/kg), administered at median age 16.8 h, was associated with background pattern worsening in 19/29 (65.5%) cases. Severe background patterns were more prevalent in post- versus pre-phenobarbitone tracings (21/29 [72%] vs. 11/29 [38%]; p = 0.01). Presence of severe pattern versus either continuous normal voltage or discontinuous normal voltage pattern post-phenobarbitone, (20/25 [80%] vs. 3/8 [38%]; p = 0.036) was associated with death or moderate-to-severe injury on MRI brain. Median time to trace recovery, when measurable, was 4 h (45 min-72 h). Conclusions: Phenobarbitone induces significant suppression on aEEG in infants with HIE undergoing TH. Development of severe aEEG background patterns after phenobarbitone may unmask a population at greater risk of abnormal outcome. (c) 2021 The Author(s) Published by S. Karger AG, Basel
Details
- Title: Subtitle
- Effect of Phenobarbitone on Amplitude-Integrated Electroencephalography in Neonates with Hypoxic-Ischemic Encephalopathy during Hypothermia
- Creators
- Poorva Deshpande - Mount Sinai HospitalAmish Jain - Mount Sinai HospitalPatrick J. McNamara - University of Toronto
- Resource Type
- Journal article
- Publication Details
- Neonatology (Basel, Switzerland), Vol.117(6), pp.721-728
- DOI
- 10.1159/000511540
- PMID
- 33412550
- NLM abbreviation
- Neonatology
- ISSN
- 1661-7800
- eISSN
- 1661-7819
- Publisher
- Karger
- Number of pages
- 8
- Language
- English
- Date published
- 02/01/2021
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984354149202771
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