TY - JOUR
T1 - An evaluation of cerebral and systemic predictors of 18-month outcomes for neonates with hypoxic ischemic encephalopathy
AU - Shellhaas, Renée A.
AU - Kushwaha, Juhi S.
AU - Plegue, Melissa A.
AU - Selewski, David T.
AU - Barks, John D.E.
N1 - Publisher Copyright:
© The Author(s) 2015.
PY - 2015/10/22
Y1 - 2015/10/22
N2 - Amplitude-integrated EEG (aEEG) is a commonly used predictor of outcome after hypoxic ischemic encephalopathy. Cerebral and systemic near-infrared spectroscopy and acute kidney injury might also have prognostic value. The authors monitored neonates with aEEG, cerebral and systemic near-infrared spectroscopy during therapeutic hypothermia, assigned an acute kidney injury stage, and measured neurodevelopmental outcome. For 18 infants, cerebral near-infrared spectroscopy variables did not differentiate between those with favorable (n = 13) versus adverse (death or moderate-severe disability; n = 5) 18-month outcomes. However, systemic rSO2 variability was higher during hours 48-72 of cooling among those with favorable outcomes (.02 < P <.03). Mean aEEG amplitude during hours 24 to 48 of cooling was higher among those with good outcomes (.027 < P <.032). The aEEG lower margin was also higher during hours 12 to 48 for those with good outcomes (.014 < P <.035). Acute kidney injury did not predict outcome (P >.05). aEEG is a useful prognostic tool for outcomes after neonatal hypoxic ischemic encephalopathy, but the role of near-infrared spectroscopy in the hypothermia-treated population remains uncertain.
AB - Amplitude-integrated EEG (aEEG) is a commonly used predictor of outcome after hypoxic ischemic encephalopathy. Cerebral and systemic near-infrared spectroscopy and acute kidney injury might also have prognostic value. The authors monitored neonates with aEEG, cerebral and systemic near-infrared spectroscopy during therapeutic hypothermia, assigned an acute kidney injury stage, and measured neurodevelopmental outcome. For 18 infants, cerebral near-infrared spectroscopy variables did not differentiate between those with favorable (n = 13) versus adverse (death or moderate-severe disability; n = 5) 18-month outcomes. However, systemic rSO2 variability was higher during hours 48-72 of cooling among those with favorable outcomes (.02 < P <.03). Mean aEEG amplitude during hours 24 to 48 of cooling was higher among those with good outcomes (.027 < P <.032). The aEEG lower margin was also higher during hours 12 to 48 for those with good outcomes (.014 < P <.035). Acute kidney injury did not predict outcome (P >.05). aEEG is a useful prognostic tool for outcomes after neonatal hypoxic ischemic encephalopathy, but the role of near-infrared spectroscopy in the hypothermia-treated population remains uncertain.
KW - Acute kidney injury
KW - Amplitude-integrated EEG
KW - Developmental outcome
KW - Hypoxic-ischemic encephalopathy
KW - Near-infrared spectroscopy
UR - http://www.scopus.com/inward/record.url?scp=84942099443&partnerID=8YFLogxK
U2 - 10.1177/0883073815573319
DO - 10.1177/0883073815573319
M3 - Article
C2 - 25724376
AN - SCOPUS:84942099443
SN - 0883-0738
VL - 30
SP - 1526
EP - 1531
JO - Journal of Child Neurology
JF - Journal of Child Neurology
IS - 11
ER -