continuous-video-electroencephalogram-during-hypoxia-ischemia

Continuous Video Electroencephalogram during Hypoxia-Ischemia in Neonatal Mice

Hypoxia ischemia is the most common cause of neonatal seizures. Animal models are crucial for understanding the mechanisms and physiology underlying ...

University of Virginia

EEG is important in monitoring neonates with hypoxic-ischemic encephalopathy (HIE) during hypothermia therapy (HT). Although EEG is used to evaluate the severity of HIE and predict outcome, HT itself may affect EEG parameters. The goal of this study is to evaluate whether core body temperature (CBT) during the rewarming phase of HT in neonates with HIE changes quantified EEG parameters. Quantified EEG parameters were reviewed in 10 neonates with HIE treated with HT. Total power, 90% spectral edge frequency, the mean and lower border of amplitude-integrated EEG (aEEG), and approximate entropy of the aEEG were calculated from 10-minute samples centered on CBT measurements. Patients were classified by clinical HIE severity and length of stay. Two-way analysis of variance was used to test interactions among CBT and EEG data. CBT had no significant effects on the quantified EEG parameters. The aEEG-average and lower border amplitudes were significantly lower in severe HIE. The aEEG-average was significantly more orderly in patients with longer length of stay, regardless of CBT. HIE severity and length of stay but not CBT affect quantified EEG. Findings suggest quantified EEG is reliable during HT. In addition, EEG may aid in predicting short-term outcome of neonates with HIE.

Clinical severity, rather than body temperature, during the rewarming phase of therapeutic hypothermia affect quantitative EEG in neonates with hypoxic ischemic encephalopathy.

Therapeutic hypothermia is standard of care in term infants with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE). The goal of this survey was to explore the attitudes of U.S. neonatologists caring for infants with HIE who fall outside of current guidelines.

Neonatal therapeutic hypothermia outside of standard guidelines: a survey of U.S. neonatologists.

We aimed to report our institution's experience with gabapentin therapy to manage agitation and pain in the neonatal intensive care unit (NICU) setting. This was a retrospective, single-center study of NICU patients admitted between January 2015 and December 2017, who received gabapentin. Data on neonatal agitation, pain, Neonatal Pain, Agitation and Sedation Scale (N-PASS) scores, neurosedative medications, and adverse events were collected. Gabapentin was initiated in 16 patients at a corrected gestational age of 44 weeks (range 36.2-75wks) for agitation (n=9), pain (n=6), and movement disorders (n=1). A neurological diagnosis was present in 13 patients. Neonatal agitation, pain, and N-PASS scores and the need for other neurosedatives were significantly decreased 14 days after treatment initiation. Gabapentin is well tolerated in neonates and infants; it is associated with decreased pain scores and decreased need for multiple neurosedative medications 2 weeks after initiation. WHAT THIS PAPER ADDS: Gabapentin is well tolerated in neonates and infants. Gabapentin decreases pain scores and the need for other neurosedative medications in neonates and infants.

Gabapentin for pain, movement disorders, and irritability in neonates and infants.

To identify circuits active during neonatal hypoxic-ischemic (HI) seizures and seizure propagation using electroencephalography (EEG), behavior, and whole-brain neuronal activity mapping.

Neuronal Circuit Activity during Neonatal Hypoxic-Ischemic Seizures in Mice.

Over 275,000 infants are born very preterm in the US each year. Fifty percent of infants born very preterm will have some degree of neurological dysfunction limiting their ability to keep up with their typically developing peers. Clinical rehabilitation for these high-risk infants has not kept pace with advances in basic science or developmental theory.

Efficacy of Supporting Play Exploration and Early Development Intervention (SPEEDI) in the First Months of Life for Infants Born Very Preterm: 3-Arm Randomized Clinical Trial Protocol.

Article	Year
Clinical severity, rather than body temperature, during the rewarming phase of therapeutic hypothermia affect quantitative EEG in neonates with hypoxic ischemic encephalopathy. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society\| PubMed ID: 21221006	2011
Neonatal therapeutic hypothermia outside of standard guidelines: a survey of U.S. neonatologists. Acta paediatrica (Oslo, Norway : 1992)\| PubMed ID: 28695691	2017
Gabapentin for pain, movement disorders, and irritability in neonates and infants. Developmental medicine and child neurology\| PubMed ID: 31343730	2020
Neuronal Circuit Activity during Neonatal Hypoxic-Ischemic Seizures in Mice. Annals of neurology\| PubMed ID: 31509619	2019
Efficacy of Supporting Play Exploration and Early Development Intervention (SPEEDI) in the First Months of Life for Infants Born Very Preterm: 3-Arm Randomized Clinical Trial Protocol. Physical therapy\| PubMed ID: 32329778	2020

Jennifer Burnsed

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