TY - JOUR
T1 - Impact of amplitude-integrated electroencephalograms on clinical care for neonates with seizures
AU - Shellhaas, Renée A.
AU - Barks, Amanda K.
N1 - Funding Information:
The authors thank John Barks, MD for assistance in the preparation of the manuscript. Support for this work was provided in part by Clinical Translational Science Award UL1RR024986 (to R.A.S.) and by the Undergraduate Research Opportunity Program of the University of Michigan (to A.K.B.).
PY - 2012/1
Y1 - 2012/1
N2 - Amplitude-integrated electroencephalography (aEEG) was recently introduced into neonatal intensive care in the United States. We evaluated whether aEEG has changed clinical care for neonates with seizures. This study included all 202 neonates treated for seizures at our hospital from 2002-2007. Neonates monitored with aEEG (n = 67) were compared with contemporary control neonates who were not monitored, despite the availability of aEEG (n = 57), and a historic control group of neonates treated for seizures before our neonatal intensive care unit initiated aEEG (n = 78). Eighty-two percent of those receiving phenobarbital (137/167) continued treatment after discharge, with no difference among groups. Adjusted for gestational age and length of stay, no difference among groups was evident in number of neuroimaging studies or number of antiepileptic drugs per patient. Fewer patients undergoing aEEG, compared with contemporary (16/67 vs 29/57, respectively, P = 0.001) or historic (n = 38/78, P = 0.002) controls, were diagnosed clinically with seizures without electrographic confirmation. We conclude that aEEG did not increase neuroimaging tests, and did not alter antiepileptic drug use. However, diagnostic precision regarding neonatal seizures improved with aEEG because fewer neonates were treated for seizures based solely on clinical findings, without electrographic confirmation.
AB - Amplitude-integrated electroencephalography (aEEG) was recently introduced into neonatal intensive care in the United States. We evaluated whether aEEG has changed clinical care for neonates with seizures. This study included all 202 neonates treated for seizures at our hospital from 2002-2007. Neonates monitored with aEEG (n = 67) were compared with contemporary control neonates who were not monitored, despite the availability of aEEG (n = 57), and a historic control group of neonates treated for seizures before our neonatal intensive care unit initiated aEEG (n = 78). Eighty-two percent of those receiving phenobarbital (137/167) continued treatment after discharge, with no difference among groups. Adjusted for gestational age and length of stay, no difference among groups was evident in number of neuroimaging studies or number of antiepileptic drugs per patient. Fewer patients undergoing aEEG, compared with contemporary (16/67 vs 29/57, respectively, P = 0.001) or historic (n = 38/78, P = 0.002) controls, were diagnosed clinically with seizures without electrographic confirmation. We conclude that aEEG did not increase neuroimaging tests, and did not alter antiepileptic drug use. However, diagnostic precision regarding neonatal seizures improved with aEEG because fewer neonates were treated for seizures based solely on clinical findings, without electrographic confirmation.
UR - http://www.scopus.com/inward/record.url?scp=84555202526&partnerID=8YFLogxK
U2 - 10.1016/j.pediatrneurol.2011.11.004
DO - 10.1016/j.pediatrneurol.2011.11.004
M3 - Article
C2 - 22196488
AN - SCOPUS:84555202526
SN - 0887-8994
VL - 46
SP - 32
EP - 35
JO - Pediatric Neurology
JF - Pediatric Neurology
IS - 1
ER -