Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia
Background: The aim of this study was to examine the predictive value of amplitude-integrated electroencephalography (aEEG) on 12-month seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia. Methods: We conducted this retrospective cohor...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-06-01
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| Series: | Biomedical Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2319417020300950 |
| _version_ | 1818001743940681728 |
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| author | Yun-Ju Chen Ming-Chou Chiang Jainn-Jim Lin I-Jun Chou Yi-Shan Wang Shu-Sing Kong I-Chen Su Elaine Chen Tze Yee Diane Mok Reyin Lien Kuang-Lin Lin |
| author_facet | Yun-Ju Chen Ming-Chou Chiang Jainn-Jim Lin I-Jun Chou Yi-Shan Wang Shu-Sing Kong I-Chen Su Elaine Chen Tze Yee Diane Mok Reyin Lien Kuang-Lin Lin |
| author_sort | Yun-Ju Chen |
| collection | DOAJ |
| description | Background: The aim of this study was to examine the predictive value of amplitude-integrated electroencephalography (aEEG) on 12-month seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia. Methods: We conducted this retrospective cohort study in a tertiary neonatal intensive care unit between May 2012 and September 2017. Neonates with HIE who received both therapeutic hypothermia (TH) and aEEG were enrolled. Results: A total of 23 infants (14 boys, nine girls) with a mean gestational age of 38.9 weeks were enrolled. Fifteen (65%) infants had moderate HIE and eight (35%) had severe HIE according to modified Sarnat staging. The mean aEEG recording time was 107.5 h. Twenty (86.9%) infants had seizure activity during the first 24 h after cooling and 14 (60.8%) had seizure activity during the first 24 h after rewarming. At 12 months, five (21.7%) infants had poor seizure outcomes. Repetitive seizures or status epilepticus pattern during the first 24 h after rewarming, but not the first 24 h after cooling, were associated with the presence of epilepsy at 12 months (p = 0.037). Conclusions: We identified a high incidence of electrographic seizures in infants with neonatal HIE treated with therapeutic hypothermia, and post-neonatal epilepsy in the children who survived after HIE. Repetitive seizures or status epilepticus pattern during the first 24 h after rewarming, but not in the first 24 h after cooling, were associated with the presence of epilepsy at 12 months. |
| first_indexed | 2024-04-14T03:38:10Z |
| format | Article |
| id | doaj.art-f5a77492e51c4600a69003ddbad75cb1 |
| institution | Directory Open Access Journal |
| issn | 2319-4170 |
| language | English |
| last_indexed | 2024-04-14T03:38:10Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj.art-f5a77492e51c4600a69003ddbad75cb12022-12-22T02:14:40ZengElsevierBiomedical Journal2319-41702020-06-01433285292Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermiaYun-Ju Chen0Ming-Chou Chiang1Jainn-Jim Lin2I-Jun Chou3Yi-Shan Wang4Shu-Sing Kong5I-Chen Su6Elaine Chen7Tze Yee Diane Mok8Reyin Lien9Kuang-Lin Lin10Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Division of Neonatology, Department of Pediatrics, Chang Gung Children's at Linkou, 5, Fusing St., Gueishan, Taoyuan 333, Taiwan.Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Corresponding author. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Children's at Linkou, 5, Fusing St., Gueishan, Taoyuan 333, Taiwan.Division of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Neonatology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chang Gung Children's Hospital at Linkou, Taoyuan, Taiwan; Study Group of Intensive and Integrated Care for Pediatric Central Nervous System (iCNS Group), Taiwan; College of Medicine, Chang Gung University, Taoyuan, TaiwanBackground: The aim of this study was to examine the predictive value of amplitude-integrated electroencephalography (aEEG) on 12-month seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy (HIE) treated with therapeutic hypothermia. Methods: We conducted this retrospective cohort study in a tertiary neonatal intensive care unit between May 2012 and September 2017. Neonates with HIE who received both therapeutic hypothermia (TH) and aEEG were enrolled. Results: A total of 23 infants (14 boys, nine girls) with a mean gestational age of 38.9 weeks were enrolled. Fifteen (65%) infants had moderate HIE and eight (35%) had severe HIE according to modified Sarnat staging. The mean aEEG recording time was 107.5 h. Twenty (86.9%) infants had seizure activity during the first 24 h after cooling and 14 (60.8%) had seizure activity during the first 24 h after rewarming. At 12 months, five (21.7%) infants had poor seizure outcomes. Repetitive seizures or status epilepticus pattern during the first 24 h after rewarming, but not the first 24 h after cooling, were associated with the presence of epilepsy at 12 months (p = 0.037). Conclusions: We identified a high incidence of electrographic seizures in infants with neonatal HIE treated with therapeutic hypothermia, and post-neonatal epilepsy in the children who survived after HIE. Repetitive seizures or status epilepticus pattern during the first 24 h after rewarming, but not in the first 24 h after cooling, were associated with the presence of epilepsy at 12 months.http://www.sciencedirect.com/science/article/pii/S2319417020300950Amplitude-integrated electroencephalographySeizure outcomeNeonatal hypoxic-ischemic encephalopathyTherapeutic hypothermia |
| spellingShingle | Yun-Ju Chen Ming-Chou Chiang Jainn-Jim Lin I-Jun Chou Yi-Shan Wang Shu-Sing Kong I-Chen Su Elaine Chen Tze Yee Diane Mok Reyin Lien Kuang-Lin Lin Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia Biomedical Journal Amplitude-integrated electroencephalography Seizure outcome Neonatal hypoxic-ischemic encephalopathy Therapeutic hypothermia |
| title | Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia |
| title_full | Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia |
| title_fullStr | Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia |
| title_full_unstemmed | Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia |
| title_short | Seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic-ischemic encephalopathy following therapeutic hypothermia |
| title_sort | seizures severity during rewarming can predict seizure outcomes of infants with neonatal hypoxic ischemic encephalopathy following therapeutic hypothermia |
| topic | Amplitude-integrated electroencephalography Seizure outcome Neonatal hypoxic-ischemic encephalopathy Therapeutic hypothermia |
| url | http://www.sciencedirect.com/science/article/pii/S2319417020300950 |
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