title: Clinical utility of early amplitude integrated EEG in monitoring term newborns at risk of neurological injury.
abstract: OBJECTIVE
  to test the clinical utility of an early amplitude-integrated electroencephalography (aEEG) to predict short-term neurological outcome in term newborns at risk of neurology injury.
  
  
  METHODS
  this was a prospective, descriptive study. The inclusion criteria were neonatal encephalopathy, neurologic disturbances, and severe respiratory distress syndrome. Sensitivity, specificity, positive and negative predictive values, and likelihood ratio (LR) were calculated. Clinical and demographic data were analyzed. Neurological outcome was defined as the sum of clinical, electroimaging, and neuroimaging findings.
  
  
  RESULTS
  ten of the 21 monitored infants (48%) presented altered short-term neurologic outcome. The aEEG had 90% sensitivity, 82% specificity, 82% positive predictive value, and 90% negative predictive value. The positive LR was 4.95, and the negative LR was 0.12. In three of 12 (25%) encephalopathic infants, the aEEG allowed for a better definition of the severity of their condition. Seizures were detected in eight infants (38%), all subclinical at baseline, and none had a normal aEEG background pattern. The status of three infants (43%) evolved and required two or more drugs for treatment.
  
  
  CONCLUSIONS
  in infants with encephalopathy or other severe illness, aEEG disturbances occur frequently. aEEG provided a better classification of the severity of encephalopathy, detected early subclinical seizures, and allowed for monitoring of the response to treatment. aEEG was a useful tool at the neonatal intensive care unit for predicting poor short-term neurological outcomes for all sick newborn.
authors.affiliation: Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: ptoso@med.puc.cl.
authors.forename: Paulina A
authors.initials: PA
authors.lastname: Toso
authors.affiliation: Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Alvaro J
authors.initials: AJ
authors.lastname: González
authors.affiliation: Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: María E
authors.initials: ME
authors.lastname: Pérez
authors.affiliation: Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Javier
authors.initials: J
authors.lastname: Kattan
authors.affiliation: Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Fabres
authors.affiliation: Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: José L
authors.initials: JL
authors.lastname: Tapia
authors.affiliation: Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Hernán S
authors.initials: HS
authors.lastname: González
mesh_terms: D016001:Confidence Intervals; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis / Q000503:physiopathology*; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000503:physiopathology*; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis; D012680:Sensitivity and Specificity; D047929:Term Birth; D013997:Time Factors
keywords: Amplitude integrated electroencephalography (aEEG); Convulsões; Eletroencefalograma de amplitude integrada (aEEG); Encefalopatia hipóxico-isquêmica (EHI); Hypoxic ischemic encephalopathy (HIE); Neonatal intensive care; Seizures; Terapia intensiva neonatal