Journal article
Role of amplitude-integrated electroencephalography in neonates with cardiovascular compromise
Journal of critical care, Vol.25(2), pp.317-321
2010
DOI: 10.1016/j.jcrc.2008.11.008
PMID: 19327328
Abstract
Neonates with congenital heart disease (CHD) and persistent pulmonary hypertension of the newborn (PPHN) represent conditions with increased risk of abnormal neurologic outcome. The role of aEEG in disorders where cerebral perfusion/oxygenation is affected by cardiac or pulmonary disease is unknown.
The aim of the study was to characterize amplitude-integrated electroencephalography (aEEG) traces in nonasphyxiated neonates with cardiorespiratory compromise secondary to PPHN or CHD.
Three hundred sixty-three aEEG records (June 2004-November 2006) were reviewed to identify neonates with a diagnosis of isolated CHD or PPHN. Clinical course, critical interventions, and neurodiagnostic investigation data were collected. The aEEG traces were reviewed by a single blinded expert and classified according to background activity (normal, moderate, or severely abnormal) and presence of seizures. The frequency of abnormal aEEG in both groups and its relationship to recognized markers of abnormal neurologic outcome (electrophysiology [EP] testing and neuroimaging [ultrasound (USS), computerized tomography, and magnetic resonance imaging] was studied.
Thirty neonates (PPHN [n = 20], CHD [n = 10]) were reviewed at a mean gestation of 39.2 ± 1.1 weeks and weight of 3375 ± 565g. Neonates with PPHN had lower Apgar scores at 1-minute (
P = .02) and were significantly more likely to require inotropic support (
P < .001), inhaled nitric oxide (
P = .001), or surfactant (
P = .01). An abnormal aEEG was found in 15 (50%) babies, but rates did not differ between CHD (n = 6) and PPHN (n = 9). The rates of abnormal composite neurologic outcome (2/3 of abnormal EP, neuroimaging, or neurologic examination) were significantly higher in neonates with abnormal aEEG. An abnormal magnetic resonance imaging was seen in 4 of 5 neonates with abnormal aEEG.
The risk of abnormal aEEG is high in sick neonates with PPHN or complex CHD. Prospective evaluation of the relationship between aEEG recordings in these disorders and acute cardiorespiratory physiology, comprehensive neuroimaging, and long-term patient outcomes is needed.
Details
- Title: Subtitle
- Role of amplitude-integrated electroencephalography in neonates with cardiovascular compromise
- Creators
- Walid I El-Naggar - Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada M5G 1X8Matthew Keyzers - Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada M5G 1X8Patrick J McNamara - Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada M5G 1X8
- Resource Type
- Journal article
- Publication Details
- Journal of critical care, Vol.25(2), pp.317-321
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jcrc.2008.11.008
- PMID
- 19327328
- ISSN
- 0883-9441
- eISSN
- 1557-8615
- Language
- English
- Date published
- 2010
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093599602771
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