Decreased aEEG continuity and baseline variability in the first 48 hours of life associated with poor short-term outcome in neonates born before 29 weeks gestation.
Amplitude-integrated electroencephalography (aEEG) provides us with a method of assessing brain activity in critically ill neonates. In extremely premature neonates, the aEEG trace is predominantly discontinuous, making it difficult to distinguish between a "normal" and "abnormal" trace. We measured aEEG activity in the first 48 h of life in neonates born before 29-wk gestation and used both visual and quantitative analysis of the aEEG data to assess differences in neonates with poor short-term outcome [death or peri/intraventricular hemorrhage (P/IVH)] compared with those who survived without P/IVH to identify features of an abnormal aEEG. On quantitative analysis, EEG continuity <80% at 10-microV level was a sensitive and specific marker of poor short-term outcome. By using this marker, we identified 83% of neonates who died or developed grade 3 or 4 IVH and 60% of neonates who developed grades 1 or 2 IVH, with a positive predictive value for death or any IVH of 73% and a negative predictive value of 86%. Absence of sleep-wake cycling with baseline variability <2 microV was the strongest predictor of outcome using visual analysis alone.
Bowen
Jennifer R
JR
Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales 2065, Australia.
Paradisis
Mary
M
Shah
Dharmesh
D
D004569:Electroencephalography; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009517:New South Wales; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors