104. Multiparametric neurophysiological assessment in Neonatal-ICU: Methodology and registration technique

Abstract

Standardise an Integrated Multiparametric Neurophysiological Assessment (IMNA) simultaneously recording Video-EEG (VEEG), Cascade-Somatosensory-Evocated-Potentials (CSEPs), Cerebral-Function-Monitoring (CFM) and Density-Spectral-Analysis (DSA); to a complete data’s temporal correlation, using the advantages of each recording. We performed 1 h-short-monitoring-IMNA in 98 newborns (71 fullterms-27 preterms) in Neonatal-ICU; respecting SEPs-topographic derivation cerebral potentials were recorded from front-central-temporal-occipital areas, including the cervical and usual polygraphic ones. We used EBneuro monitoring-device (NeMus2-acquisition-stimulation-hardware, ICU.NET-software), disposable surface-recording electrodes (Ambu-Neuroline), surface-small-size cup (3 mm) AgCl-electrodes (BIONEN), abrasive-gel and conductive-cream (TEN20). The acquisition-panel is composed of modular-windows in demand: VEEG-recording (8bipolar-channels Fp2-C4;C4-O2;Fp2-T4;T4-O2;Fp1-C3;C3-O1;Fp1-T3;T3-O1); parameters (0.3 s;70 Hz;10 μV/mm); impedences <10 KΩ. 4bipolars-channels-CFM (scale 20–120 μV)-DSA (visible stripe 0–32 Hz, color-map-interval 0–10 μV2) extrapolated from the EEG-montage. CSEPs (N1–N13 components) in sequence (Cc-Fz;Cc-Ci;Cv7-Fz) obtained by bilaterally alternated-1 Hz-stimulus from median nerve (200 ms;10–20 mA; 50 average), referred to the template-potential. CSEP’s components in trends. 1 h-short-monitoring-IMNA was able to identify a neonate’s sleep-cycle and well tolerated from the newborns (95%), with truthful registrations. IMNA-monitoring was easily performed in Neonatal-ICU, obtaining well recognizable, reliable, on–off-line assessible data, in particular CSEP. This new assessment, using 2 electrodes (Fz-Cv7) and 2 stimulatories in addition respect of the traditional VEEG, is useful to obtain more instrumental data in a little extra-time, extending the neurological informations in Neonatal-ICU.