title: Rewarming affects EEG background in term newborns with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia.
abstract: OBJECTIVE
  To investigate how rewarming impacts the evolution of EEG background in neonates with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).
  
  
  METHODS
  We recruited a retrospective cohort of 15 consecutive newborns with moderate (9) and severe (6) HIE monitored with a continuous EEG during TH and at least 12h after its end. EEG background was analyzed using conventional visual and quantitative EEG analysis methods including EEG discontinuity, absolute and relative spectral magnitudes. One patient with seizures on rewarming was excluded from analyses.
  
  
  RESULTS
  Visual and quantitative analyses demonstrated significant changes in EEG background from pre- to post-rewarming, characterized by an increased EEG discontinuity, more pronounced in newborns with severe compared to moderate HIE. Neonates with moderate HIE also had an increase in the relative magnitude of slower delta and a decrease in higher frequency theta and alpha waves with rewarming.
  
  
  CONCLUSIONS
  Rewarming affects EEG background in HIE newborns undergoing TH, which may represent a transient adaptive response or reflect an evolving brain injury.
  
  
  CONCLUSIONS
  EEG background impairment induced by rewarming may represent a biomarker of evolving encephalopathy in HIE newborns undergoing TH and underscores the importance of continuously monitoring the brain health in critically ill neonates.
authors.affiliation: Division of Neurology, CHU Sainte Justine, Department of Neurosciences and Paediatrics, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada. Electronic address: abirca@hotmail.com.
authors.forename: Ala
authors.initials: A
authors.lastname: Birca
authors.affiliation: Division of Neurology, CHU Sainte Justine, Department of Neurosciences and Paediatrics, University of Montreal, Montreal, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Lortie
authors.affiliation: CHU Sainte-Justine Research Center, Montreal, Canada.
authors.forename: Veronica
authors.initials: V
authors.lastname: Birca
authors.affiliation: Department of Radiology, CHU Sainte Justine, University of Montreal, Montreal, Canada.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Decarie
authors.affiliation: Neonatology, CHU Sainte Justine, Department of Paediatrics, University of Montreal, Montreal, Canada.
authors.forename: Annie
authors.initials: A
authors.lastname: Veilleux
authors.affiliation: Department of Psychology, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Gallagher
authors.affiliation: Department of Radiology, CHU Sainte Justine, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Dehaes
authors.affiliation: Neonatology, CHU Sainte Justine, Department of Paediatrics, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Lodygensky
authors.affiliation: Division of Neurology, CHU Sainte Justine, Department of Neurosciences and Paediatrics, University of Montreal, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada.
authors.forename: Lionel
authors.initials: L
authors.lastname: Carmant
mesh_terms: D015331:Cohort Studies; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D017694:Rewarming / Q000379:methods*; D047929:Term Birth / Q000502:physiology*
keywords: Continuous EEG monitoring; Hypoxic–ischemic encephalopathy; Newborn; Quantitative EEG analysis; Rewarming; Therapeutic hypothermia