The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis.
OBJECTIVE
To investigate the longitudinal course and prognostic value of amplitude integrated EEG (aEEG) in infants with neonatal sepsis or meningitis.


METHODS
Amplitude integrated EEG recordings of 22 infants with sepsis/meningitis were retrospectively evaluated. Mean gestational age was 38 weeks (range: 34-42 weeks). Thirteen infants had meningitis. Survivors were seen for neurological follow-up. Four infants died, two were severely abnormal at 24 months. Amplitude integrated EEG background pattern, sleep wake cycling (SWC) and electrographic seizure activity (EA) were appraised.


RESULTS
All infants with continuous low voltage or flat trace on aEEG (n = 4) had an adverse outcome. Low voltage aEEGs (n = 9) had a positive LR (LR+) for an adverse outcome of 5.3 (95% CI: 1.9-14.8) at 6 h and 8.3 (95% CI: 1.3-55) at 24 h after admission. EA was more frequent in infants with adverse outcome (p < 0.01) and had a LR+ for adverse outcome of 10.6 (95% CI: 1.5-76). SWC appeared more frequent in infants with good outcome (p < 0.05).


CONCLUSIONS
Low voltage background pattern, SWC and EA on aEEG are helpful to predict neurological outcome in infants with neonatal sepsis or meningitis.
ter Horst
H J
HJ
Division of Neonatology, Department of Pediatrics, University Medical Center Groningen, The Netherlands. h.j.ter.horst@bkk.umcg.nl
van Olffen
M
M
Remmelts
H J
HJ
de Vries
H
H
Bos
A F
AF
D004569:Electroencephalography / Q000379:methods*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008137:Longitudinal Studies; D008581:Meningitis / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012640:Seizures; D018805:Sepsis / Q000175:diagnosis* / Q000503:physiopathology; D012890:Sleep; D014851:Wakefulness