335 Long-Term Continuous EEG-Monitoring in Very Premature Children

Abstract

Background: The immature brain is vulnerable for insults the first days of life. It is desirable to have a method for continuous monitoring of the brain in this critical period of time. Unfortunately, available methods like time-compressed amplitude integrated EEG based on only few channels, have definite limitations.Objective: To devise a method for stable continuous long-term EEG monitoring covering both hemispheres of the brain.Methods: After consent from the parents and approval from the Ethics Committee thirty premature babies below 30 weeks of gestational age were included within twelve hours after birth. We used a digital EEG system (NERVUS a/S) for continuous EEG monitoring during their first three days of life. 10 electrodes were symmetrically placed over both hemispheres leaving space over vertex for ultrasound measurements to be made when needed.Results: Out of 30 patients we succeeded to perform full-length (72 hours) recordings in 28 cases. Successful recordings were characterized by stable electrode contacts with impedances within the normal range which were repeatedly checked every third hour. There were no apparent signs that the scalp electrodes disturbed the patients. Digital recordings make it possible to quantify general and focal changes in the brain as well as seizure activity.The predictive value of the EEG changes for later outcome will be established when we compare early EEG patterns to the patients' status at 2 years of age.Conclusions: We have demonstrated that it is feasible to perform long-term continuous EEG monitoring in very premature children. This should be of importance in order to detect general or focal brain dysfunction where rapid intervention is advantageous.