An Evaluation of Cerebral and Systemic Predictors of 18-Month Outcomes for Neonates With Hypoxic Ischemic Encephalopathy

J Child Neurol. 2015 Oct;30(11):1526-31. doi: 10.1177/0883073815573319. Epub 2015 Feb 27.

Abstract

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.

Keywords: acute kidney injury; amplitude-integrated EEG; developmental outcome; hypoxic-ischemic encephalopathy; near-infrared spectroscopy.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / physiopathology*
  • Electroencephalography* / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Hypothermia, Induced* / methods
  • Hypoxia-Ischemia, Brain / diagnosis*
  • Hypoxia-Ischemia, Brain / physiopathology
  • Hypoxia-Ischemia, Brain / therapy*
  • Infant, Newborn
  • Male
  • Pilot Projects
  • Prognosis
  • Spectroscopy, Near-Infrared* / methods
  • Time Factors
  • Treatment Outcome