The prognostic value of early aEEG in asphyxiated infants undergoing systemic hypothermia treatment

• Published in: Acta Paediatrica 2010-04, Vol.99 (4), p.531-536
• Main Authors: Hallberg, B, Grossmann, K, Bartocci, M, Blennow, M
• Format: Article
• Language: English
• Subjects: Amplitude-integrated EEG; Asphyxia Neonatorum - complications; Asphyxia Neonatorum - mortality; Asphyxia Neonatorum - therapy; Biological and medical sciences; Birth asphyxia; Early Diagnosis; Electroencephalography - methods; Follow-Up Studies; General aspects; Humans; Hypothermia, Induced - methods; Hypoxia-Ischemia, Brain - diagnosis; Hypoxia-Ischemia, Brain - etiology; Hypoxia-Ischemia, Brain - mortality; Hypoxic-ischaemic encephalopathy; Infant, Newborn; Medical sciences; Medicin och hälsovetenskap; Patient Selection; Prognosis; Term Birth; Therapeutic hypothermia; Treatment Outcome
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/j.1651-2227.2009.01653.x

Background:  Induced moderate hypothermia (HT) for 72 h has been shown to reduce the combined outcome of death or severe neurodevelopmental disabilities in asphyxiated full‐term infants. A pathological amplitude integrated EEG background as early as 3–6 h after birth, has been shown to correlate to poor prognosis. Aim:  The aim of this study was to investigate the correlation between amplitude integrated EEG during HT treatment and short‐term outcome in asphyxiated full‐term infants with moderate/severe hypoxic‐ischaemic encephalopathy. Methods:  Between December 2006 and December 2007, 24 infants were treated with moderate HT (33.5°C for 72 h) using a cooling mattress. Motor functions were assessed at 4 and 12 months of age. Results:  Of the total birth cohort of 28,837 infants, 26 infants fulfilled the criteria for HT treatment (0.9/1000) of whom 23 was treated with HT and all of these infants had available amplitude integrated EEG data. Normal 1‐year outcome was found in 10/15 infants with severely abnormal burst‐suppression pattern or worse at 6 h of age. Severe abnormalities were found to be significantly predictive for abnormal outcome after 36 h. Conclusion:  Among asphyxiated infants treated with HT, only those who had aEEG abnormalities persisting at and beyond 24 h after birth showed poor neurological outcome at 1 year.