Application of amplitude-integrated electroencephalography in term neonates with brain injury

Abstract

Objective To explore the value of amplitude-integrated electroencephalography(aEEG) in diagnosis and prognosis in term newborns with brain injury. Methods One hundred and thirty consecutive patients with brain injury admitted in NICU were prospectively enrolled in the study from Nov 2013 to Apr 2015.The monitoring of aEEG was done at 1d, 4d, 7d, respectively.Clinical data were collected and compared with the result of aEEG. Results All the cases of newborns with abnormal aEEG background: discontinuous voltage(109 cases), continuous low voltage(12 cases), flat(4 cases). The epileptic activity were recorded in 33 cases, and 15 cases showed burst-suppression; sleep wake cycle: mature(32 cases), immature(54 cases), no sleep wake cycle(39 cases). The judgment of abnormal level: 70 cases had mildly abnormal aEEG, severe abnormalities 60 cases, and no significant difference in different types of diseases(χ2=6.176, P=0.19). Recent prognosis: the death of mild and severe abnormalities were 1 case, 12 cases, respectively, there were significant differences(χ2=12.76, P<0.001). Developmental quotient(DQ) of these newborns were followed up for more than 6 months, and there were significant differences in mild, severe abnormal aEEG in them with DQ≥85 and DQ<85(χ2=33.195, P<0.001). The sensitivity of aEEG in severe abnormal aEEG was 68.75%, the specificity was 78.68%, and the positive and negative predictive values of aEEG were 77.19% and 70.58%, respectively.The results of aEEG classification and sleep wake cycle were correlated with the prognosis of the patients(r=0.505, 0.507, respectively, P<0.001). Conclusion aEEG can be used to monitor brain function, and it is helpful to evaluation of early diagnosis and prognosis. Key words: Electroencephalography; Amplitude-integrated electroencephalography; Brain injury; Infant, newborn; Prognosis