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Early single-channel aEEG/EEG predicts outcome in very preterm infants
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
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2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 7, 719-726 p.Article in journal (Refereed) Published
Abstract [en]

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 (2230) weeks. Methods: Amplitude-integrated electroencephalogram/EEG recorded during the first 72 h and analysed over 012, 1224, 2448 and 4872 h, for background pattern, sleepwake 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 7580% accuracy already at 24 postnatal hours in VPT infants, also in infants with no early indication of brain injury.

Place, publisher, year, edition, pages
2012. Vol. 101, no 7, 719-726 p.
Keyword [en]
Burst suppression, Cranial ultrasound, Interburst interval, Neurodevelopmental impairment, Seizure
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-178558DOI: 10.1111/j.1651-2227.2012.02677.xISI: 000304715200022OAI: oai:DiVA.org:uu-178558DiVA: diva2:542370
Available from: 2012-07-31 Created: 2012-07-31 Last updated: 2012-07-31Bibliographically approved

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Wikström, SverreHellström-Westas, Lena
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