title: Accuracy of amplitude-integrated electroencephalography in the prediction of neurodevelopmental outcome in asphyxiated infants receiving hypothermia treatment.
abstract: OBJECTIVE
  Both hypothermia and central nervous system (CNS) drugs may alter the predictive accuracy of amplitude-integrated electroencephalography (aEEG) in hypoxic-ischaemic encephalopathy (HIE). The aim was to assess the predictive value of aEEG in hypothermia-treated HIE infants. Furthermore, we intended to investigate the association of cumulative doses of CNS drugs with aEEG recovery.
  
  
  METHODS
  Seventy term HIE infants treated with hypothermia for 72 h were continuously monitored by single-channel aEEG. Doses of administered morphine, phenobarbitone and midazolam were recorded. Poor outcome was defined as death or severe neurodevelopmental delay at 18-24 months (Bayley Scales of Infant Development II), good outcome as absence of these criteria.
  
  
  RESULTS
  Poor outcome n = 26, good outcome n = 44. Positive predictive values (PPV) of an abnormal background pattern to predict poor outcome were 0.5 at 6 h; 0.65 at 24 h; 0.82 at 48 h and 0.92 at 60 h. All infants who developed sleep-wake cycling (SWC) had a favourable outcome; the nondevelopment of SWC resulted in a PPV of 0.73 for a poor outcome. Cumulative doses of the investigated drugs did not differ between infants having an onset of a recovered background pattern before or after 24 h.
  
  
  CONCLUSIONS
  Amplitude-integrated electroencephalography provides reliable prediction of outcome from the 48th hour during hypothermia in HIE infants. Commonly used CNS drugs in HIE infants do not significantly delay aEEG recovery.
authors.affiliation: 1st Department of Paediatrics, Semmelweis University, Budapest, Hungary. cseko.anna@gmail.com
authors.forename: A J
authors.initials: AJ
authors.lastname: Csekő
authors.forename: M
authors.initials: M
authors.lastname: Bangó
authors.forename: P
authors.initials: P
authors.lastname: Lakatos
authors.forename: J
authors.initials: J
authors.lastname: Kárdási
authors.forename: L
authors.initials: L
authors.lastname: Pusztai
authors.forename: M
authors.initials: M
authors.lastname: Szabó
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology; D001238:Asphyxia Neonatorum / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D002657:Child Development; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D007231:Infant, Newborn; D008297:Male; D009420:Nervous System / Q000254:growth & development* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants; D006993:Hypnotics and Sedatives