| Objective:To discuss the background activity features of amplitude-integrated electroen-cephalography (aEEG) in perinatal asphyxiated full-term neonates, evaluate thecorrelation between the results of aEEG background activity and the severity ofasphyxia and the significance of aEEG in early diagnosis of newborns with perinatalasphyxia brain damage, find a preferable new routine technique which will be of greatbenefit to the cerebral function monitor(CFM) in NICU.Methods:62asphyxiated full-term infants and36healthy term infants (all of them werehospitalized in NICU of the First Affiliated Hospital of Nanchang University fromJan.2011to Feb.2012) were monitored the aEEG by NicoletOne CFM in the first6hours soon after birth. The results of aEEG recordings were judged in threeaspects,which included the background activity(classified as continuous normalvoltage, discontinuous normal voltage, burst suppression, continuous extremelylow-voltage, and flat), the sleep-wake cycling(classified as no SWC, immature SWC,developed SWC) and the seizure activity(classified as single seizure, repetitiveseizures, status epilepticus). Statistical analysis included spearman correlationanalysis and χ2test are by using SPSS17.0software.Results:In the mildly asphyxiated group,23had continuous activity,21had discontin-uous background,1had low voltage,1had no sleep-wake cycling,14had immaturesleep-wake cycling,30had developed sleep-wake cycling, and3had single seizure;While in the severely asphyxiated group,5had continuous activity,6haddiscontinuous background,1had burst-suppression,5had low voltage,6had nosleep-wake cycling,5had immature sleep-wake cycling,6had developed sleep-wakecycling, and4had seizure activity(3had single seizure,1had status epilepticus); Thecontrol group were normal excluding1discontinuous background, and1had immature sleep-wake cycling,35had developed sleep-wake cycling. Among the25brain damage infants diagnosed with the clinical symptoms and radiographicinspection,23were HIE, and2were intracranial hemorrhage.12newborns with HIEhad recent multiorgan injury complication. There was positive correlation betweenthe change of aEEG and the severity of asphyxia(P＜0.001), also between thesleep-wake cycling and the severity of asphyxia(P＜0.001), and between thecategorization of aEEG and the clinical graduation of HIE(P＜0.01). The incidenceof epileptic seizure activity was higher in severely asphyxiated group than others(P＜0.01). The incidence of recent organ injury was lower in HIE infants with normalaEEG than abnormal aEEG, and the more severely abnormal aEEG the higherincidence of recent organ injury.Conclusions:1. There was a positive correlation between the change of aEEG backgroundactivity and the severity of asphyxia, also between the sleep-wake cycling and theseverity of asphyxia. The asphyxiated newborns had different types of abnormalbackground activity depending on the severity of asphyxia, and had less mature or nosleep-wake cycling as the more of the severity of asphyxia The incidence of epilepticseizure activity was higher in the severely asphyxiated group than others.2. There was positive correlation between the categorization of aEEG and theclinical graduation of HIE. The mild HIE had abnormal or mildly abnormal aEEGbackground activity, while most of the moderate or severe HIE had abnormal aEEGbackground activity and no or immature sleep-wake cycling. The incidence ofepileptic seizure activity was higher in the moderate or severe HIE than the mild.AEEG in the first6hours after birth can evaluate the severity of HIE.3. The incidence of recent organ injury was lower in HIE infants with normalaEEG than abnormal aEEG, and infants with severely abnormal aEEG had higherincidence of recent organ injury.4. AEEG in the first6hours after birth can be used to provide theory evidencefor the early diagnosis and intervention of perinatal asphyxia brain damage. AEEG isa new bedside monitoring technique which can be used in NICU to monitor the cerebral function with possible brain injury. |
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