The prognostic value of early aEEG in asphyxiated infants undergoing systemic hypothermia treatment.
BACKGROUND
Induced moderate hypothermia (HT) for 72 h has been shown to reduce the combined outcome of death or severe neurodevelopmental disabilities in asphyxiated full-term infants. A pathological amplitude integrated EEG background as early as 3-6 h after birth, has been shown to correlate to poor prognosis.


OBJECTIVE
The aim of this study was to investigate the correlation between amplitude integrated EEG during HT treatment and short-term outcome in asphyxiated full-term infants with moderate/severe hypoxic-ischaemic encephalopathy.


METHODS
Between December 2006 and December 2007, 24 infants were treated with moderate HT (33.5 degrees C for 72 h) using a cooling mattress. Motor functions were assessed at 4 and 12 months of age.


RESULTS
Of the total birth cohort of 28,837 infants, 26 infants fulfilled the criteria for HT treatment (0.9/1000) of whom 23 was treated with HT and all of these infants had available amplitude integrated EEG data. Normal 1-year outcome was found in 10/15 infants with severely abnormal burst-suppression pattern or worse at 6 h of age. Severe abnormalities were found to be significantly predictive for abnormal outcome after 36 h.


CONCLUSIONS
Among asphyxiated infants treated with HT, only those who had aEEG abnormalities persisting at and beyond 24 h after birth showed poor neurological outcome at 1 year.
Hallberg
B
B
Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden. boubou.hallberg@ki.se
Grossmann
K
K
Bartocci
M
M
Blennow
M
M
D001238:Asphyxia Neonatorum / Q000150:complications / Q000401:mortality / Q000628:therapy*; D042241:Early Diagnosis; D004569:Electroencephalography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D007231:Infant, Newborn; D018579:Patient Selection; D011379:Prognosis; D047929:Term Birth; D016896:Treatment Outcome