Abstract
Objective Hypoxic-ischemic encephalopathy (HIE) still is a major cause of neonatal mortality and morbidity. The amplitude-integrated electroencephalogram (aEEG) is reliable for prediction of outcome in asphyxiated neonates. Near-infrared spectroscopy (NIRS) offers the possibility to continuously monitor cerebral oxygen saturation. Only few data have been published on the combined use of NIRS and aEEG in neonates cooled for HIE. The aim of this study was to investigate the correlation between continuous aEEG and NIRS during the first days of life in HIE. Methods aEEG: Brain function was measured continuously immediately after the hypoxic event, during hypothermia, until the end of rewarming using a Olympic 6000 (Natus©). aEEG tracings were analysed for background patterns, appearance of sleep-wake cycling and the presence of seizure activity. Furthermore, a combined aEEG-score was calculated for the timeperiod before, during and after hypothermia. NIRS: Patients were monitored using NIRS (INVOS System by Covidien©) for the mentioned time period. Changes in regional cerebral oxygen saturation (rcSO2) were measured. Fractional tissue oxygen extraction (FTOE) was calculated for the entire duration of the measurement in order to investigate the balance between oxygen delivery and oxygen supply. Results A significant correlation coefficient (CorrC) was found between SWZ and rcSO2 post cooling (CorrC: 0.78) as well as FTOE during (CorrC: 0.69) and post cooling (CorrC: 0.95). Furthermore, a significant CorrC was found between the total aEEG score and rcSO2 post cooling (CorrC: 0.58) as well as FTOE during (CorrC: 0.61) and post cooling (CorrC: 0.79). Conclusion Our data show a significant correlation between continuous aEEG monitoring, which is a valuable and reliable method for prediction of neurodevelopmental outcome in neonates with HIE, and NIRS measurements. Therefore, we suggest that NIRS can serve as an additional prognostic tool in HIE.
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