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Early single-channel aEEG/EEG predicts outcome in very preterm infants.

Wikström, Sverre; Pupp, Ingrid LU ; Rosén, Ingmar LU ; Norman, Elisabeth LU ; Fellman, Vineta LU ; Ley, David LU and Hellström-Westas, Lena LU (2012) In Acta paediatrica (Oslo, Norway : 1992) 101(7). p.719-726
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta paediatrica (Oslo, Norway : 1992)
volume
101
issue
7
pages
719 - 726
publisher
Taylor & Francis
external identifiers
  • WOS:000304715200022
  • PMID:22530996
  • Scopus:84861802748
ISSN
1651-2227
DOI
10.1111/j.1651-2227.2012.02677.x
language
English
LU publication?
yes
id
1e1e3ffa-28f9-4000-8db1-ff333b834f53 (old id 2519078)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22530996?dopt=Abstract
date added to LUP
2012-05-06 20:00:17
date last changed
2016-11-27 04:30:11
@misc{1e1e3ffa-28f9-4000-8db1-ff333b834f53,
  abstract     = {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. <br/><br>
<br/><br>
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. <br/><br>
<br/><br>
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 &gt; 6 sec (74% correctly predicted; PPV 67%, NPV 79%) and IB% &gt; 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%). <br/><br>
<br/><br>
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.},
  author       = {Wikström, Sverre and Pupp, Ingrid and Rosén, Ingmar and Norman, Elisabeth and Fellman, Vineta and Ley, David and Hellström-Westas, Lena},
  issn         = {1651-2227},
  language     = {eng},
  number       = {7},
  pages        = {719--726},
  publisher    = {ARRAY(0x9680d40)},
  series       = {Acta paediatrica (Oslo, Norway : 1992)},
  title        = {Early single-channel aEEG/EEG predicts outcome in very preterm infants.},
  url          = {http://dx.doi.org/10.1111/j.1651-2227.2012.02677.x},
  volume       = {101},
  year         = {2012},
}