EEG Findings in Term Infants Born with Hypoxic Ischemic Encephalopathy and Correlation with Neurological Outcomes
Abstract number :
1.155
Submission category :
3. Neurophysiology / 3B. ICU EEG
Year :
2022
Submission ID :
2204403
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:24 AM
Authors :
Khaled Al-robaidi, MD – University of Alabama Medical Center; Salman Rashid, MD – University of Alabama Medical Center; Vivek Shukla, MD – University of Alabama Medical Center; Manimaran Ramani, MD – University of Alabama Medical Center
Rationale: Infants born with hypoxic ischemic encephalopathy (HIE) can be at risk for significant morbidity and mortality. It has been shown that HIE can lead to suboptimal neurological outcomes or even death. Neonatal electroencephalography (EEG) has become a valuable tool for infants born with suspected HIE to help with early identification of a possible brain injury or subclinical seizures and thus early management. Some studies have suggested that utilizing this tool can be valuable in predicting short- and long-term outcomes.
Methods: A comprehensive chart review was performed on all infants born with suspected HIE and enrolled in the NeuroNICU-B.R.A.I.N. program at the University of Alabama Medical Center. This program was designed to focus on early VEEG monitoring and neuroprotective protocols. EEG findings were then analyzed and correlated with different clinical outcomes.
Results: Between June 2018 and June 2021, 51 infants (25 M / 26 F) with mean gestational age of (37.3) met the clinical criteria for HIE with mean arterial cord pH of (6.9). Among those enrolled, 44 infants (86%) had evidence of variable degrees of encephalopathy on EEG initiated within 24 hours of birth, 14 infants (27%) had seizures or rhythmic cortical irritability on EEG, and 7 infants (14%) had a normal EEG. Among those infants with an EEG confirmed seizures, 90% had a prolonged NICU stay for over two weeks (odds ratio 19.6, P value 0.008), 100% had an abnormal neurodevelopmental exam upon discharge, and 28% died during their NICU stay (odds ratio 7.0, P value 0.038).
Conclusions: Our study suggests that infants born with HIE can be at significant risk for morbidity and mortality, and this risk can be further increased in infants with abnormal EEG. Early VEEG monitoring can be vital in early detection of subclinical seizures or focal cortical irritability which can help with earlier management and predicting outcomes.
Funding: None
Neurophysiology