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Sommer, C.
The prognostic significance of cerebral function monitoring in severely asphyxiated term born infants.
[ Dissertation ] Graz Medical University; 2003. pp.87.


Authors Med Uni Graz:
Sommer Constanze
Reiterer Friedrich
Urlesberger Berndt

Birth asphyxia is the most common cause of perinatally acquired brain injury in full-term infants. The measurement of the corical brain activity by Cerebral function Monitoring (CFM), in the literature alternatively named amplitude integrated EEG (aEEG), has proved, due to its prognostic accuracy (80-85%), to be the most eligible method to identify risk population at very early date in order to provide untimely opportunities for neuroprotective treatments. The aim of the study was to determine the significance of cortical brain activity measured by Cerebral Function Monitoring (CFM) for predicting the neurological outcome in severely asphyxiated infants during the first 72 hours of life. Methods: Twenty-eight term born neonates with severe perinatal asphyxia, admitted to the neonatal intensive care unit of the university hospital in Groningen, the Netherlands, were studied retrospectively. CFM patterns were assessed for the first 72 hours after birth using pattern recognition: Continuous normal voltage (CNV), discontinuous normal voltage (DNV), burst suppression (BS), epileptic status (ES), continuous low voltage (CLV) and flat trace (FT, or isoelectric). In addition, isolated epileptic activity (EA) was noted, irrespective of the background pattern. The sequence of patterns of each individual infant was graphically displayed on the time axis for the first 72 hours of life. Time of birth was regarded as t=0. Finally, the sequences of CFM patterns were assigned to one of the three groups of neurological findings (normal, mildly abnormal, severely abnormal) assessed at follow-up through paediatric and neurological examination at 12 months age for all and at 18 months age for eighteen children. Standard EEG was recorded in 20 of the 28 infants within 24 hours after birth. Findings were compared to CFM patterns performed at the same time. Results: Fifteen infants had normal neurological findings at follow-up. Twelve of them showed exclusively normal voltage CFM traces (DNV and CNV). Two infants had periods of burst suppression (BS) and one a period of continuous low voltage (CLV) at about 6 hours after birth. Four infants had mildly abnormal neurological findings at follow-up. Their CFM patterns showed predominantly normal traces (DNV and CNV) but two of them performed periods of burst suppression (BS), one during the first 12 hours after birth, the other between 24 and 36 hours. Three infants had severely abnormal neurological findings at follow-up.

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