title: Early amplitude-integrated electroencephalography for monitoring neonates at high risk for brain injury.
abstract: OBJECTIVE
  This study aimed to correlate amplitude-integrated electroencephalography findings with early outcomes, measured by mortality and neuroimaging findings, in a prospective cohort of infants at high risk for brain injury in this center in Brazil.
  
  
  METHODS
  This blinded prospective cohort study evaluated 23 preterm infants below 31 weeks of gestational age and 17 infants diagnosed with hypoxic-ischemic encephalopathy secondary to perinatal asphyxia, with gestational age greater than 36 weeks, monitored with amplitude-integrated electroencephalography in a public tertiary center from February 2014 to January 2015. Background activity (classified as continuous, discontinuous high-voltage, discontinuous low-voltage, burst-suppression, continuous low-voltage, or flat trace), presence of sleep-wake cycling, and presence of seizures were evaluated. Cranial ultrasonography in preterm infants and cranial magnetic resonance imaging in infants with hypoxic-ischemic encephalopathy were performed.
  
  
  RESULTS
  In the preterm group, pathological trace or discontinuous low-voltage pattern (p=0.03) and absence of sleep-wake cycling (p=0.019) were associated with mortality and brain injury assessed by cranial ultrasonography. In patients with hypoxic-ischemic encephalopathy, seizure patterns on amplitude-integrated electroencephalography traces were associated with mortality or brain lesion in cranial magnetic resonance imaging (p=0.005).
  
  
  CONCLUSIONS
  This study supports previous results and demonstrates the utility of amplitude-integrated electroencephalography for monitoring brain function and predicting early outcome in the studied groups of infants at high risk for brain injury.
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil. Electronic address: gftvariane@hotmail.com.
authors.forename: Gabriel Fernando Todeschi
authors.initials: GFT
authors.lastname: Variane
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil.
authors.forename: Maurício
authors.initials: M
authors.lastname: Magalhães
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil.
authors.forename: Renato
authors.initials: R
authors.lastname: Gasperine
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Radiologia, São Paulo, SP, Brazil.
authors.forename: Heitor Castelo Branco Rodrigues
authors.initials: HCBR
authors.lastname: Alves
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Radiologia, São Paulo, SP, Brazil.
authors.forename: Thiago Luiz Pereira Donoso
authors.initials: TLPD
authors.lastname: Scoppetta
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil.
authors.forename: Rodrigo de Jesus Gonçalves
authors.initials: RJG
authors.lastname: Figueredo
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil.
authors.forename: Francisco Paulo Martins
authors.initials: FPM
authors.lastname: Rodrigues
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Netto
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil; Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Patologia, São Paulo, SP, Brazil.
authors.forename: Marcelo Jenne
authors.initials: MJ
authors.lastname: Mimica
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, São Paulo, SP, Brazil.
authors.forename: Clery Bernardi
authors.initials: CB
authors.lastname: Gallacci
mesh_terms: D001034:Apgar Score; D001930:Brain Injuries / Q000175:diagnosis* / Q000209:etiology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies
keywords: Amplitude-integrated EEG; Brain injury; EEG de amplitude integrada; Early outcome; Lesão cerebral; Newborn; Recém-nascido; Resultado precoce