Document Detail


Early single-channel aEEG/EEG predicts outcome in very preterm infants.
MedLine Citation:
PMID:  22530996     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To characterize early amplitude-integrated electroencephalogram (aEEG) and single-channel EEG (aEEG/EEG) in very preterm (VPT) infants for prediction of long-term outcome.
PATIENTS: Forty-nine infants with median (range) gestational age of 25 (22-30) weeks.
METHODS: Amplitude-integrated electroencephalogram/EEG recorded during the first 72 h and analysed over 0-12, 12-24, 24-48 and 48-72 h, for background pattern, sleep-wake cycling, seizures, interburst intervals (IBI) and interburst percentage (IB%). In total, 2614 h of single-channel EEG examined for seizures. Survivors were assessed at 2 years corrected age with a neurological examination and Bayley Scales of Infant Development-II. Poor outcome was defined as death or survival with neurodevelopmental impairment. Good outcome was defined as survival without impairment.
RESULTS: Thirty infants had good outcome. Poor outcome (n = 19) was associated with depressed aEEG/EEG already during the first 12 h (p = 0.023), and with prolonged IBI and higher IB% at 24 h. Seizures were present in 43% of the infants and associated with intraventricular haemorrhages but not with outcome. Best predictors of poor outcome were burst-suppression pattern [76% correctly predicted; positive predictive value (PPV) 63%, negative predictive value (NPV) 91%], IBI > 6 sec (74% correctly predicted; PPV 67%, NPV 79%) and IB% > 55% at 24 h age (79% correctly predicted; PPV 72%, NPV 80%). In 35 infants with normal cerebral ultrasound during the first 3 days, outcome was correctly predicted in 82% by IB% (PPV 82%, NPV 83%).
CONCLUSION: Long-term outcome can be predicted by aEEG/EEG with 75-80% accuracy already at 24 postnatal hours in VPT infants, also in infants with no early indication of brain injury.
Authors:
Sverre Wikström; Ingrid Hansen Pupp; Ingmar Rosén; Elisabeth Norman; Vineta Fellman; David Ley; Lena Hellström-Westas
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-24
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  101     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-07     Completed Date:  2012-10-11     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  719-26     Citation Subset:  IM    
Copyright Information:
© 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
Affiliation:
Department of Women's and Children's Health, Uppsala University, Sweden. sverre.wikstrom@liv.se
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MeSH Terms
Descriptor/Qualifier:
Blindness / diagnosis,  physiopathology
Brain Damage, Chronic / diagnosis*,  mortality,  physiopathology
Cerebral Palsy / diagnosis,  physiopathology
Child, Preschool
Deafness / diagnosis,  physiopathology
Developmental Disabilities / diagnosis*,  mortality,  physiopathology
Electroencephalography* / methods
Female
Follow-Up Studies
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnosis*,  mortality,  physiopathology
Male
Predictive Value of Tests
Prognosis
Prospective Studies
Seizures / diagnosis,  mortality,  physiopathology
Sensitivity and Specificity
Survival Rate
Comments/Corrections
Comment In:
Acta Paediatr. 2012 Jul;101(7):690-1   [PMID:  22536836 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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