TY - JOUR
T1 - Towards multimodal brain monitoring in asphyxiated newborns with amplitude-integrated EEG and simultaneous somatosensory evoked potentials
AU - Nevalainen, Päivi
AU - Metsäranta, Marjo
AU - Marchi, Viviana
AU - Toiviainen-Salo, Sanna
AU - Vanhatalo, Sampsa
AU - Lauronen, Leena
N1 - Funding Information:
We thank MD PhD Tuula Lönnqvist for support and ideas for this project and Marita Suni and Laura Sinisalo for their help with data management. This work was supported by the University of Helsinki and Helsinki University Hospital researcher position (Author PN), Helsinki University Hospital Project Funds [ Y920016024 , Y122417013 , and 1C27012974 ], Academy of Finland grants no. 314602 and 314573 , as well as project grants from Foundation for Pediatric Research , Aivosäätiö , and Juselius Foundation . The sponsors were not involved in the collection, analysis and interpretation of data or in the writing of the manuscript.
Funding Information:
We thank MD PhD Tuula L?nnqvist for support and ideas for this project and Marita Suni and Laura Sinisalo for their help with data management. This work was supported by the University of Helsinki and Helsinki University Hospital researcher position (Author PN), Helsinki University Hospital Project Funds [Y920016024, Y122417013, and 1C27012974], Academy of Finland grants no. 314602 and 314573, as well as project grants from Foundation for Pediatric Research, Aivos??ti?, and Juselius Foundation. The sponsors were not involved in the collection, analysis and interpretation of data or in the writing of the manuscript.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/2
Y1 - 2020/2
N2 - Background: Somatosensory evoked potentials (SEPs) offer an additional bedside tool for outcome prediction after perinatal asphyxia. Aims: To assess the reliability of SEPs recorded with bifrontoparietal amplitude-integrated electroencephalography (aEEG) brain monitoring setup for outcome prediction in asphyxiated newborns undergoing therapeutic hypothermia. Study design: Retrospective observational single-center study. Subjects: 27 consecutive asphyxiated full- or near-term newborns (25 under hypothermia) that underwent median nerve aEEG-SEPs as part of their clinical evaluation at the neonatal intensive care unit of Helsinki University Hospital. Outcome measures: aEEG-SEP classification (present, absent or unreliable) was compared to classification of SEPs recorded with a full EEG montage (EEG-SEP), and outcome determined from medical records at approximately 12-months-age. Unfavorable outcome included death, cerebral palsy, or severe epilepsy. Results: The aEEG-SEP and EEG-SEP classifications were concordant in 21 of the 22 newborns with both recordings available. All five newborns with bilaterally absent aEEG-SEPs had absent EEG-SEPs and the four with outcome information available had an unfavorable outcome (one was lost to follow-up). Of the newborns with aEEG-SEPs present, all with follow-up exams available had bilaterally present EEG-SEPs and a favorable outcome (one was lost to follow-up). One newborn with unilaterally absent aEEG-SEP at 25 h of age had bilaterally present EEG-SEPs on the next day, and a favorable outcome. Conclusions: aEEG-SEPs recorded during therapeutic hypothermia on the first postnatal days are reliable for assessing brain injury severity. Adding SEP into routine aEEG brain monitoring offers an additional tool for very early outcome prediction after birth asphyxia.
AB - Background: Somatosensory evoked potentials (SEPs) offer an additional bedside tool for outcome prediction after perinatal asphyxia. Aims: To assess the reliability of SEPs recorded with bifrontoparietal amplitude-integrated electroencephalography (aEEG) brain monitoring setup for outcome prediction in asphyxiated newborns undergoing therapeutic hypothermia. Study design: Retrospective observational single-center study. Subjects: 27 consecutive asphyxiated full- or near-term newborns (25 under hypothermia) that underwent median nerve aEEG-SEPs as part of their clinical evaluation at the neonatal intensive care unit of Helsinki University Hospital. Outcome measures: aEEG-SEP classification (present, absent or unreliable) was compared to classification of SEPs recorded with a full EEG montage (EEG-SEP), and outcome determined from medical records at approximately 12-months-age. Unfavorable outcome included death, cerebral palsy, or severe epilepsy. Results: The aEEG-SEP and EEG-SEP classifications were concordant in 21 of the 22 newborns with both recordings available. All five newborns with bilaterally absent aEEG-SEPs had absent EEG-SEPs and the four with outcome information available had an unfavorable outcome (one was lost to follow-up). Of the newborns with aEEG-SEPs present, all with follow-up exams available had bilaterally present EEG-SEPs and a favorable outcome (one was lost to follow-up). One newborn with unilaterally absent aEEG-SEP at 25 h of age had bilaterally present EEG-SEPs on the next day, and a favorable outcome. Conclusions: aEEG-SEPs recorded during therapeutic hypothermia on the first postnatal days are reliable for assessing brain injury severity. Adding SEP into routine aEEG brain monitoring offers an additional tool for very early outcome prediction after birth asphyxia.
KW - Amplitude-integrated electroencephalography (aEEG)
KW - Asphyxia
KW - Brain monitoring
KW - Electroencephalography (EEG)
KW - Newborn
KW - Somatosensory evoked potentials (SEPs)
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U2 - 10.1016/j.earlhumdev.2020.105287
DO - 10.1016/j.earlhumdev.2020.105287
M3 - Article
C2 - 33310460
AN - SCOPUS:85097467693
VL - 153
JO - Early Human Development
JF - Early Human Development
SN - 0378-3782
M1 - 105287
ER -