title: Cot-side electroencephalography monitoring is not clinically useful in the detection of mild neonatal hypoglycemia.
abstract: OBJECTIVE
  To determine whether there is a relationship between electroencephalography patterns and hypoglycemia, by using simultaneous cot-side amplitude integrated electroencephalography (aEEG) and continuous interstitial glucose monitoring, and whether non-glucose cerebral fuels modified these patterns.
  
  
  METHODS
  Eligible babies were ≥ 32 weeks gestation, at risk for hypoglycemia, and admitted to the neonatal intensive care unit. Electrodes were placed in C3-P3, C4-P4 O1-O2 montages. A continuous interstitial glucose sensor was placed subcutaneously, and blood glucose was measured by using the glucose oxidase method. Non-glucose cerebral fuels were measured at study entry, exit, and during recognized hypoglycemia.
  
  
  RESULTS
  A total of 101 babies were enrolled, with a median weight of 2179 g and gestation of 35 weeks. Twenty-four of the babies had aEEG recordings, and glucose concentrations were low (< 2.6 mM). There were 103 episodes of low glucose concentrations lasting 5 to 475 minutes, but no observable changes in aEEG variables. Plasma concentrations of lactate, beta-hydroxybutyrate, and glycerol were low and did not alter during hypoglycemia.
  
  
  CONCLUSIONS
  Cot-side aEEG was not useful for the detection of neurological changes during mild hypoglycemia. Plasma concentrations of non-glucose cerebral fuels were low and unlikely to provide substantial neuroprotection.
authors.affiliation: Newborn Intensive Care Unit, Waikato District Health Board, Hamilton, New Zealand.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Harris
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Weston
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Williams
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Pleasants
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Battin
authors.forename: Claire G
authors.initials: CG
authors.lastname: Spooner
authors.forename: Jane E
authors.initials: JE
authors.lastname: Harding
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D004569:Electroencephalography; D005949:Glucose Oxidase / Q000097:blood; D005990:Glycerol / Q000097:blood; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008991:Monitoring, Physiologic; D019095:Point-of-Care Systems
chemical_list: D001786:Blood Glucose; D019344:Lactic Acid; D005949:Glucose Oxidase; D005990:Glycerol; D020155:3-Hydroxybutyric Acid