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Cot-side electroencephalography for outcome prediction in preterm infants: observational study.
MedLine Citation:
PMID:  20870908     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective To assess the use of two-channel electroencephalographical (EEG) recordings for predicting adverse neurodevelopmental outcome (death or Bayley II mental developmental index/psychomotor developmental index < 70) in extremely preterm infants and to determine the relationship between quantitative continuity measures and a specialist neurophysiologist assessment of the same EEG segment for predicting outcome. Design Observational study. Setting The study was conducted in a neonatal intensive care unit. Patients Preterm infants born <29 weeks' gestation. Interventions Two-channel EEGs using the reBRM2 monitor (BrainZ Instruments, Auckland, New Zealand) within 48 h of delivery. One-hour segments were analysed, blinded to the clinical outcome, by off-line quantitative analysis of continuity and a review of the raw EEG by a neurophysiologist. Main outcome measures Developmental assessment at a median of 15 months' corrected age. Results 76 infants had an EEG within 48 h of delivery and a developmental assessment. The analysed segment of the EEG was obtained at 24 (3-48) h of age (median (range)). The neurophysiologist's assessment was a better predictor of adverse outcome than the continuity measures (positive predictive value 95% CI 75 (54% to 96%) vs 41 (22% to 60) at 25-µV threshold, negative predictive value 88 (80% to 96%) vs 84 (74% to 94%) and positive likelihood ratio 9.0 (3.2 to 24.6) vs 2.0 (1.2 to 3.6)). All the infants with definite seizures identified by the neurophysiologist had poor outcomes. Conclusions Modified cot-side EEG has potential to assist with identification of extremely preterm infants at risk for adverse neurodevelopmental outcomes. However, analysis by a neurophysiologist performed better than the currently available continuity analyses.
Authors:
Claire R West; Jane E Harding; Chris E Williams; Melinda Nolan; Malcolm R Battin
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Publication Detail:
Type:  Journal Article     Date:  2010-09-24
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  96     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F108-13     Citation Subset:  AIM; IM    
Affiliation:
Neonatal Intensive Care Unit, Middlemore Hospital, Private Bag 93311, Otahuhu, Manukau 1640, Auckland, New Zealand; westc@middlemore.co.nz.
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